TITLE:
Immediate and Intermediate Results of Patent Ductus Artriosus Transcatheter Closure in Kurdistan (Multicenter Experience)
AUTHORS:
Aso F. Salih, Abass A. Al-Rabaty, Zuhair I. Al-Nasiry
KEYWORDS:
Patent Ductus Artriosus, Catheterization, Amplatzer Device, Embolization, Kurdistan
JOURNAL NAME:
World Journal of Cardiovascular Surgery,
Vol.6 No.5,
May
24,
2016
ABSTRACT: Background: Patent Ductus Artriosus (PDA) is abnormal vascular communication between aorta
and pulmonary artery and it is a common congenital heart anomaly seen in pediatric practice
forming 5% - 10% of all congenital heart defects. A retrospective study aims to review our experience
and determine the efficacy and safety of transcatheter PDA closure in different age groups
and has the procedure replaced the conventional surgical closure of the PDA in the majority of the
cases. To assess the results and outcomes of early experience, transcatheter closure of patent
ductus Arteriosus in all three cardiac centers in Kurdistan, using the Amplatzer Duct Occluder
type I and II (ADO), and Cook coil for the first time in Kurdistan are analyzed. Patients & Methods:
A total of three hundred and nine patients which included 228 females & 81 males were diagnosed
to have PDA, between March 2008 to February 2011 in all three cardiac centers in Kurdistan,
namely Hawler, Sulaimani and Duhok cardiac centers, where they underwent transcatheter closure
of the PDA with ADO type I and II. The common age on closure was 1 - 5 years old (range 5.5
months old to 32 years old), and weight ranged from 6 kg to 58 kg. We retrospectively analyzed
medical records, echocardiography, angiographic and hemodynamic data and follow-up results of
the patients. Patients included in the study were according to standard recommendation for transcatheter
closure of PDA, and in any age they should be above 6 kilograms with exclusion of cases
with pulmonary hypertension and interrupted IVC. Results: Among 309 cases did catheterization
procedures, the ratio of female to male ratio was 2.6:1 and the age of doing PDA closure at time of
procedure was between 5.5 months old to 33 years old, the mean age was 6.3 ± 6.5 years old and
the weight ranges between 6 kg and 58 kg, mean of 11.5 ± 7.5 kg. The most commonly used device was Amplatzer I PDA device with high closure success rate of 97.1% after 6 and 12 months followup
and the first case of Amplatzer II PDA Device closure done in Iraq and Kurdistan. There was
immediate & complete closure in 271 on angiography. Complication was noted as embolized PDA
device to Right Pulmonary Artery (RPA) in two patients, one of them retrieved by cath and other
one by surgery. Conclusion: Transcatheter Amplatzer duct occluder is safe and effective in closing
PDA in most patients with PDA even large as much as 10 mm and the advantage of new Amplatzer
PDA II device allows small delivery sheath in which it can be done for children with less than 6 kg
with fewer complications. Disadvantage is that it cannot close more than 6 mm PDA.