TRANSCATHETER CLOSURE OF PATENT DUCTUS-ARTERIOSUS IN CHILDREN AND ADULTS

Aim. To describe the initial New Zealand experience of transcatheter p atent ductus arteriosus closure in adults and children. Methods. Twent y-three children beyond infancy and four adults with isolated patent d uctus arteriosus were selected for transcatheter umbrella closure. Ras hkind umbrellas were placed across the patent ductus arteriosus throug h a percutaneously inserted long venous sheath using the Mullins techn ique. Results. In 25 of the 27 patients a Rashkind umbrella was placed accurately. In two patients the umbrella could not be placed accurate ly: in one the procedure was abandoned uneventfully and in one the umb rella embolised to the right pulmonary artery necessitating surgical r emoval of the device and patent ductus arteriosus closure. There were no other significant complications. A second umbrella insertion is pla nned in two children for a significant residual leak at 1-year follow up. Conclusions. Transcatheter patent ductus arteriosus closure is a l ow risk and usually effective alternative to surgical closure for the majority of patients beyond infancy.