PERCUTANEOUS COIL OCCLUSION OF PATENT DUCTUS-ARTERIOSUS

Objective: To determine the success rate and safety of percutaneous pa tent ductus arteriosus (PDA) coil occlusion. Design: Thirty consecutiv e pediatric patients with small to moderate-size PDAs (minimum diamete r less than or equal to 4 mm) underwent percutaneous coil occlusion. T he results were assessed by angiography and echocardiography. The mean age was 5.1 +/- 4.2 years (range, 0.8 to 18.8 years); mean weight was 19.2 +/- 10.3 kg (range, 8.1 to 40.0 kg), The mean minimum diameter o f the PDA was 1.8 +/- 0.8 mm (range, 1.0 to 4.0 mm). Results: PDA occl usion was achieved with one coil in 24 patients, 2 coils in 3 patients and 3 coils in 3 patients, The mean coil/PDA diameter ratio was 2.5 /- 0.5, Immediately after coil occlusion, 29 PDAs had no flow by angio graphy; one had a small residual shunt. There were no significant comp lications. In the first 24 hours after coil implantation, echocardiogr aphy showed complete occlusion in 28 patients, a small left-to-right s hunt in the same patient that had a residual shunt by angiography, and a trace shunt in one additional patient, In the two patients with res idual flow by echocardiography, follow-up ultrasonography revealed no residual shunt 1 and 3 months later. At a mean follow-up of 11.8 +/- 9 .3 months (range, 0 to 36.0 months), there was no PDA flow by color Do ppler echocardiography in any of the 30 patients. Conclusion: Coil occ lusion is a safe and effective method of percutaneous closure of small to moderate-size PDAs. The largest PDA that can be closed with this t echnique remains to be determined.