Complications of Transcatheter Closure in Patent Ductus Arteriosus Patients

Abstract

Background: Published studies have shown excellent success rates and also low rates of life-threatening complications with trans-catheter closure of patent ductus arteriosus (PDA). However, most studies to date have been conducted in developed nations and reports from developing countries such as Iran are lacking. Objectives: To report our experience with trans-catheter closure of patent ductus arteriosus (PDA) and compare two devices and complications. Patients and Methods: From 2007 to 2011, 72 consecutive PDA cases were prospectively enrolled. For PDAs ≤ 2 mm, the coiling method was employed whereas patients with PDA > 2 mm received Amplatzer duct occlusion (ADO). Success was defined as trivial residual shunt (< 1 mm) in the echocardiography performed 30 minutes after the procedure. After the procedure, the patients were admitted to the pediatric cardiology ward and observed for 72 hours during which the occurrence of major and minor complications was monitored. Major complications included cardiac arrest, displacement and/or embolization of the device and patient needing blood transfusion due to severe hemorrhage. Sampling was based on convenience method and the patients who had significant pulmonary artery hypertension were excluded from our study. Statistical analyses were done using SPSS software version 23 (IBM corp., New York, United States). Continuous variables are presented as mean ± standard deviation. The Mann-Whitney U test was used to compare the differences between two independent groups. Categorical variables were depicted as proportions and compared across the intervention groups, using Chi-square with Fisher’s exact text where appropriate. In all tests, a P value < 0.05 was deemed necessary to reject the null hypothesis. Results: With the coiling (n = 39) and Amplatzer methods (n = 33), successful closure was observed totally and recovered with no major complications. Frequent complications were benign arrhythmia (44.4%), and hemorrhage in 1 (1.4%) of the patients. Complication rate did not differ between the two techniques (P > 0.05). Conclusions: Excellent and comparable success rates for both closure techniques were observed and no major complications were observed.