TRANSCATHETER VASCULAR OCCLUSION OF THE SMALL PATENT DUCTUS-ARTERIOSUS - AN ALTERNATIVE METHOD

The current strategies concerning a small (less than or equal to 2 mm) patent ductus arteriosus (PDA) include surgical ligation, transcathet er implantation of the Rashkind occluder device, or no intervention re quiring indefinite endocarditis precautions. Five patients have underg one successful transcatheter closure of a small-caliber PDA utilizing a single 3 mm Gianturco occluder coil as an alternative to surgical li gation. The coil was delivered to traverse the narrowest dimension of the PDA, leaving loops of coil in both the pulmonary and aortic ends o f the ductus. All PDAs were successfully occluded, and the duration of hospitalization for all patients was 1 day. At latest follow-up (11 /- 2 months), echocardiography demonstrates complete ductus occlusion in all patients, with no obstruction to left pulmonary arterial or des cending aortic flow. Transcatheter coil occlusion of the small ductus is an easily accomplished, safe, effective alternative to surgical Lig ation, thereby avoiding a lateral thoracotomy incision, shortening hos pitalization, and reducing costs.