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Midterm Result after Transcatheter Occlusion of Patent Ductus Arteriosus with Rashkind PDA Umbrella Device

Journal of the Korean Pediatric Society 1995;38(5):668-674.
Published online May 15, 1995.
Midterm Result after Transcatheter Occlusion of Patent Ductus Arteriosus with Rashkind PDA Umbrella Device
Chung Il Noh, Eun Sook Han, Ho Sung Kim, Jung Yun Choi, Yong Soo Yun
Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
Rashkind PDA Umbrella 기구를 사용한 동맥관 개존증 단락 페쇄술 시행후 중기간의 결과 분석
노정일, 한은숙, 김호성, 최정연, 윤용수
서울대학교 의과대학 소아과학교실
Abstract
Purpose
: To evaluate the appropriateness of the transcatheter occlusion with Rashkind um-brella occlusion device
Methods
: Among the 54 cases who had been tried transcatheter closure of patent ductus ar teriosus from January, 1992 till December, 1993 at Seoul National Univerity Children's Hospital, the first follow-up evaluation with Doppler echocardioram were done in 43 cases at the mean i-nterval of 11 months(¡¾6 months) and the second examination in 28 cases at 6 months later af-ter the first examination.
Results
: In 2 cases, immediate operation was performed due to dislodgement of the device in the aorta. The mean age of the successful 52 cases was 5lmonths(¡¾33 months) and the ra-nge was between 5 months and 13 years of age. There were 3 cases of postprocedure anemia, 2 of whom were due to mild hemolytic anemia; 2 cases of femoral artery thrombosis which nee-ded thrombectomy. At the initial follow-up, residual shunt was detected in 30.2%(13/43) and D oppler velocity increase in left pulmonary artery over im/sec compared to main pulmonary arte-ry was detected in 9.3%(4/43). At the second evaluation, there were no cases of spontaneous obliteration of shunt(0/11). When change of Dopper velocity increase in left pulmonary artery of more than 0.4m/sec was regarded as significant, velocity was increased in 17.9%(5/28); decre- ased in 10.7%(3/28). There were no cases of endarteritis during the follow-up period. The resid-ual shunt was not related to age, weight, PDA size, PDA morphology, device size or the positio- n of the device.
Conclusion
: Transcatheter occlusion of PDA with Rashkind umbrella is effective and safe. However, meticulous performance of the procedure and careful selection of patient and device are necessary to reduce the possible immediate and late complications. Further evaluation is n eeded to define the outcome of the clinically insignificant residual shunt regarding the possible endarteritis and the outcome of increased velocity in left pulmonary artery.
Key Words: Patent ductus arteriosus, Rashkind device, Chidren


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