Transcatheter closure of the Patent Ductus Arteriosus: an intention to treat analysis

Sheridan, Bennett J., Ward, Cameron J., Anderson, Benjamin W. and Justo, Robert N. (2013) Transcatheter closure of the Patent Ductus Arteriosus: an intention to treat analysis. Heart Lung and Circulation, 22 6: 428-432. doi:10.1016/j.hlc.2012.12.007

Author Sheridan, Bennett J.
Ward, Cameron J.
Anderson, Benjamin W.
Justo, Robert N.
Title Transcatheter closure of the Patent Ductus Arteriosus: an intention to treat analysis
Journal name Heart Lung and Circulation   Check publisher's open access policy
ISSN 1443-9506
Publication date 2013-06-01
Year available 2013
Sub-type Article (original research)
DOI 10.1016/j.hlc.2012.12.007
Volume 22
Issue 6
Start page 428
End page 432
Total pages 5
Place of publication Chatswood Australia
Publisher Elsevier Australia
Language eng
Formatted abstract
Background: In patients with patent ductus arteriosus (PDA), transcatheter closure is the current procedure of choice.
There are multiple devices available with limited current comparative data and varied recommendations for device
Objective: To assess the efficacy and safety of the Flipper coil (FC) and the Amplatzer Duct Occluder (ADO).
Methods: Anintention to treat analysis of all children admitted to the catheter laboratory at a single institution for occlusion of PDA from 2003 to 2011 was performed. Patient and device selection were determined by the treating physician. Standard techniques for FC and ADO implantation were used.
Results: Two hundred and twenty eight children with median weight of 14.2 kg (range; 5.5–68 kg) underwent cardiac
catheterisation, with successful occlusion in 96.2% of patients when attempted. In 16 patients, median angiographic
PDA diameter of 0.8mm (range; 0.4–1.2 mm), was considered too small to warrant closure. Eight patients with large
PDA’s underwent surgical ligation. FC was successfully used in 70 (34.3%) and ADO in 134 (66.7%) patients. ADO
patients were smaller (P = 0.004) with larger PDA’s (P < 0.0001) than the FC group. Median fluoroscopy time was longer
for ADO patients (10.1 min vs 8.0 min; P < 0.0001). ADO had a lower embolisation rate (0% vs 6.6%; P = 0.005) and a higher complete occlusion rate at follow-up (100% vs 73.4%; P < 0.0001). Length of hospital admission decreased with time in both groups.
Conclusion: Transcatheter closure of the PDA has a high degree of safety and efficacy. This study suggests that the
ADO may be the device of first choice in the current era.
Keyword Patent ductus arteriosus
Transcatheter closure
Amplatzer duct occluder
Flipper coil
Percutaneous closure
Catheter closure
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
School of Medicine Publications
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