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A new strategy for transcatheter closure of patent ductus arteriosus with recent-generation devices

Published online April 15, 2009.
A new strategy for transcatheter closure of patent ductus arteriosus with recent-generation devices
Sang Yee Kim1, Soo Hyun Lee1, Nam Kyun Kim2, Jae Young Choi2, Jun Hee Sul2
1Division of Pediatric Cardiology, Department of Pediatrics, Severance CardiovasYonsei University College of Medicine, Seoul, Koreacular Center Cardiovascular Research Institute,
2Division of Pediatric Cardiology, Department of Pediatrics, Severance Cardiovascular Center Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea
경피적 동맥관 폐쇄술에서 최근의 기구들의 전략적 이용과 결과
김상이1, 이수현1, 김남균2, 최재영2, 설준희2
1연세대학교 의과대학 소아과학교실, 심장혈관병원 심혈관연구소, 소아심장과
2연세대학교 의과대학 소아과학교실, 심장혈관병원 심혈관연구소, 소아심장과
Correspondence: 
Jae Young Choi, Email: cjy0122@yuhs.ac
Abstract
Purpose
: The aim of this study was to assess the efficacy and safety of recent-generation patent ductus arteriosus (PDA) closure devices applied by a new selection strategy according to the characteristics of each PDA.
Methods
: From February 2003 to January 2006, 138 patients underwent transcatheter closure of PDA (study group). According to the size and morphology of each ductus, a COOK Detachable Coil or "flex" PFM Nit-Occlud was used for a small ductus (group 1, n=43); "medium" PFM Nit-Occlud (group 2, n=49) for a moderate ductus; and an Amplatzer Duct Occluder (group 3, n=46) for a large ductus. The 83 patients who underwent transcatheter closure of PDA from February 2000 to January 2003 were defined as the comparison group. The Qp/Qs ratio, pulmonary/aorta pressure ratio, and MD of the ductus were compared. Immediate and follow-up results including residual shunts and complications were also evaluated and compared among groups.
Results
: In all 138 patients, complete occlusions were confirmed without major complications, while procedure failure (n=2, 2.2%), device embolization (n=1, 1.1%), and persistent residual shunt (n=4, 4.5%) were documented in the comparison group. Total complication rates were lower in the study group than in the comparison group (study group, 1.4%; comparison group, 9.0%; P<0.05).
Conclusion
: A novel strategy adopting the merits of various recent-generation devices for transcatheter closure of PDA provides excellent clinical results with minimal risk.
Key Words: n=49) for a moderate ductus, and an Amplatzer Duct Occluder (group 3


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