TRANSCATHETER OCCLUSION OF THE PATENT DUCTUS-ARTERIOSUS WITH COOK DETACHABLE COILS

Objective-To report initial experience with a new occlusion device for native and residual patent ductus arteriosus. Design-Descriptive stud y of consecutive non-randomised patients undergoing a new method of pa tent ductus arteriosus closure with detachable coils. Setting-Tertiary centres for paediatric cardiology. Patients-71 consecutive patients, aged 1.2-22 years, with a patent ductus arteriosus (PDA) underwent ele ctive transcatheter closure. 45 had native PDAs (group A) with a minim um diameter of 1.0 mm-5.0 mm (median 2.0 mm). A further 26 had undergo ne one or more previous occlusion attempts (group B). Interventions-A total of 133 detachable (Cook) spring coils were successfully implante d in 70 patients. The procedure was performed transvenously in 51 pati ents, retrograde arterially in 13, and by both routes in a further 6 p atients. One 5 mm coil migrated but was successfully retrieved. Main o utcome measures-In group A colour flow Doppler echocardiography showed that complete occlusion was achieved in 40/45 (89%) at 24 hours, 41/4 5 (91%) at 1 month, and 44/45 (98%) by 6 months post procedure. Occlus ion rates in residual PDAs were 22/25 (88%) occluded at 24 hours, 23/2 5 (92%) at 1 month, and 24/25 (96%) at 6 months follow up. Conclusions -Transcatheter occlusion using detachable (Cook) spring coils is a saf e and effective alternative to presently available devices. The delive ry system allows full retrieval of the coil until a satisfactory posit ion is obtained.