All issues > Volume 48(2); 2005

Original Article

Korean J Pediatr. 2005;48(2):158-164. Published online February 15, 2005.

Impact of Device Evolution in Transcatheter Closure of Patent Ductus Arteriosus Using Duct-Occlud Coils : Comparison of Mid-term Results

Myung Kwan MK Kim¹, Dong Ki DK Han¹, Jae Young JY Choi¹, Yuria Y Kim¹, Byung Won BW Yoo¹, Deok Young DY Choi¹, Jun Hee JH Sul¹, Sung Kue SK Lee¹

¹Division of Pediatric Cardiology, Yonsei Cardiovascular Center, Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea

Correspondence Jae Young JY Choi ,Email: cjy0122@yumc.yonsei.kr

Abstract

Purpose
: We reviewed the therapeutic results of various Duct-Occlud coils(pfm AG, K ln, Germany) to evaluate the efficacy of the most-recently modified Duct-Occlud coil(Nit-Occlud) in the transcatheter closure of patent ductus arteriosus(PDA), including large defects more than 4 mm in diameter.
Methods
: Two hundred and five patients who underwent percutaneous PDA occlusion using Duct- Occlud devices from March 1996 to December 2003 were enrolled and four types of Duct-Occlud [Standard(S), Reinforced(R), Reinforced reverse cone(RR) and Nit-Occlud(N)] were used in this study. The patients were followed up by echocardiogram and physical examination before discharge, one month, six months and 12 months after the procedure.
Results
: The rate of residual shunt according to the type of Duct-Occlud were as follows : S-54%, R-72%, RR-50%, N-14%(P<0.05 compared with other devices) at one month, S-25%, R-44%, RR- 37%, N-0%(P<0.05 compared with other devices) at six months, S-8%, R-8%, RR-4%, N-0%(P< 0.05 compared with S and R) at 12 months and later. Nit-Occlud coil showed the complete occlusion of PDA after six months of follow-up, even in 12 patients with relatively large PDA(>4 mm).
Conclusion
: The transcatheter closure of PDA using Duct-Occlud was an effective treatment and our study revealed that a Nit-Occlud coil which showed higher rate of occlusion even in PDA with large diameters over than 4 mm, was a more effective modality compared to previous devices.

Keywords :Patent ductus arteriosus , Transcatheter occlusion , Duct-Occlud