PERCUTANEOUS CLOSURE OF SMALL PATENT DUCTUS-ARTERIOSUS - COMPARISON OF RASHKIND DOUBLE-UMBRELLA DEVICE AND OCCLUDING SPRING COILS

We compared our current practice of closing small patent ductus arteri osus (PDA) with cells with our previous experience of using double-umb rellas. Twelve patients underwent percutaneous closure of a small PDA with a coil. Selection criteria were a minimal diameter of less than o r equal to 2.5 mm and angiographic type A or E. The 12 most recent, no n-consecutive patients who had undergone double-umbrella device closur e of a PDA and would presently be considered suitable candidates for s pring coil occlusion were retrospectively reviewed. The two groups wer e compared with regard to complications and immediate and midterm resu lts. Eleven of the 12 attempted PDA occlusions using spring coils were successful. The mean follow-up period was 5.8 +/- 4.6 months. Color-D oppler echocardiograms have shown no residual leaks, no turbulence in the descending aorta, and no left pulmonary artery stenosis. All 12 at tempted double-umbrella device placements were successful. The mean fo llow-up period was 16.2 +/- 5.8 months. Color-Doppler echocardiograms have shown trivial residual leaks in four patients and mild turbulent flow in the left pulmonary artery In one patient. There was no signifi cant difference between the two groups in demographic and hemodynamic data. Although the mean follow-up time was significantly longer in the patients who underwent double-umbrella closure, there was significant ly more color-Doppler echocardiographic evidence of residual flow (P < 0.03). Small PDA closure with coils is effective, resulting in less r esidual leaks compared with the double-umbrella device. (C) 1996 Wiley -Liss, Inc.