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Coil occlusion of the patent ductus arteriosus: lessons learned
- Source :
- Cardiovascular and interventional radiology. 23(2)
- Publication Year :
- 2000
-
Abstract
- To review the clinical outcomes of catheter-directed coil occlusion (coil occlusion) of persistently patent ductus arteriosus (PDA) at a pediatric tertiary care hospital.A retrospective review of all patients referred to the Cardiac Catheterization Laboratory for coil occlusion at our institution was performed. Twenty-one consecutive patients (12 female) underwent coil occlusion and follow-up between May 1995 and December 1997. We undertook PDA occlusion if: (a) the PDA narrowed to less than 4 mm on echocardiogram and (b) the minimum body weight was approximately 10 kg. Standard right and retrograde left heart catheterization was performed, followed by coil occlusion. Color-flow mapping (CFM) was used intra-procedurally to confirm occlusion of the PDA with a follow-up study several weeks later.The median age and weight of the patients were 33 months and 13.2 kg, respectively. Fourteen patients received one coil, with six requiring a second coil and one requiring multiple coils. Initial follow-up was at a median of 2.4 months. At latest follow-up, 2 patients still have persistent flow at the ductal level. The coils were deployed without complication or embolization.A review of our first 21 cases demonstrated three important lessons: (1) the maximum diameter of the PDA suitable for coil occlusion is approximately 3 mm; (2) CFM must show complete obliteration of flow in the catheterization lab in order to ensure occlusion of the PDA at follow-up; and (3) the Jackson detachable system allows for precise placement of the coil, often within another coil.
- Subjects :
- Adult
Male
congenital, hereditary, and neonatal diseases and abnormalities
medicine.medical_specialty
Adolescent
Catheterization
Blood vessel prosthesis
Ductus arteriosus
Internal medicine
medicine.artery
medicine
Coil occlusion
Humans
Radiology, Nuclear Medicine and imaging
cardiovascular diseases
Child
Ductus Arteriosus, Patent
Aorta
DUCTUS ARTERIOSUS PATENT
business.industry
Infant
Tertiary care hospital
Surgery
Blood Vessel Prosthesis
medicine.anatomical_structure
Child, Preschool
embryonic structures
cardiovascular system
Cardiology
Female
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 01741551
- Volume :
- 23
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- Cardiovascular and interventional radiology
- Accession number :
- edsair.doi.dedup.....2c775a64f39256171ae6fec5834a64fc