REACTIVITY OF PATENT DUCTUS-ARTERIOSUS - MANAGEMENT DURING TRANSCATHETER OCCLUSION

Transcatheter closure of patent ductus arteriosus Botalli (PDA) has be come a routine procedure. Only PDA in low birth weight infants, and sh ort and wide open PDA in small children could not be closed by means o f catheter technology. Different transcatheter closure systems are ava ilable now. We report on a premature infant now 16 month old weighting 6,8 kg were surgery seemed inadvisable. After angiography a funnel-sh aped PDA seemed to be suitable for closure by a Ductocclud spiral coil (PFM company). The spiral coil could not be set in place safely becau se meanwhile the pulmonary PDA month had widened after angiography. Tr anscatheter closure then was successful using a 17 mm Rashkind double umbrella (Bard company) in modified implantation technique with a 8 fr ench introduction set, and special attention to avoid the isthmus of t he aorta and pulmonary artery stenosis. Discussion: Ductal reactivity at an age of 16 months seems unusual. Even at this age one has to be a ware of possibly dramatic changes of the shape of the ductus during ex amination. Experience with several transcatheter PDA-closure systems i s necessary for the successful closure even in cases of unexpected cha nges of shape of PDA.