RESULTS OF TRANSCATHETER CLOSURE OF THE PATENT DUCTUS-ARTERIOSUS WITHTHE BOTALLOOCCLUDER

Objectives. Evaluation of the immediate and long-term efficacy of a no vel method of transvenous closure of the patent ductus arteriosus was the purpose of this study. Background. In 1981 at the First Moscow Hos pital, a new method of transvenous patent ductus arteriosus closure wi th the Botallooccluder was developed. Methods. Transvenous closure of the patent ductus arteriosus with the Botallooccluder was carried out in 273 patients. All patients were regularly followed up as outpatient s at intervals of 3, 6 and 12 months after intervention. A total of 17 1 patients were examined at a mean of 3.2 +/- 1.1 years (range 1 to 8) after the procedure. Late evaluation with cardiac catheterization was performed in 62 patients (36%); 50 (29%) of these 62 also underwent r ight heart catheterization. Results. Successful implantation was achie ved in 266 patients (97%). The late follow-up findings testify to the favorable clinical course, with disappearance of the continuous murmur and regression of the electrocardiographic signs of ventricular overl oading in the vast majority of patients. In no case after complete pat ent ductus arteriosus closure was a late ductus recanalization observe d. No patient had even a minor degree of postprocedural lower extremit y venous damage. In 29 patients (24%), the femoral artery was imaged b y ultrasonography at late follow-up, without evidence of any vascular abnormality. Conclusions. The clinical data suggest high long-term eff icacy and reliability of this technique. Introducer sheaths (12F to 16 F outer diameter) did not cause any long term entry site sequelae.