Transcatheter occlusion of the patent ductus arteriosus: a comparison of two devices

  • M. K. El Mallah
  • A. J. Sands
  • F. A. Casey
  • B. G. Craig
  • H. C. Mulholland
Original Paper
  • 33 Downloads

Abstract

Background

Transcatheter occlusion of the arterial duct is a safe and effective alternative to surgical closure. The Rashkind umbrella occluder and the Cook coil are two established devices, although the former is no longer manufactured.

Aims

To assess any difference in outcomes between the use of the Cook detachable coil and the Rashkind double umbrella in patent ductus arteriosus (PDA) occlusion.

Methods

A retrospective study of 77 patients in whom PDA occlusion was attempted using the Cook detachable PDA coil from March 1996 to March 2000. A comparison was carried out with patients in whom occlusion was attempted using the Rashkind double umbrella between 1989 and 1996.

Results

The rate of immediate complete occlusion was 24% compared with 29.9% for the Rashkind device. The figure for complete occlusion after 24 hours with the PDA coil was 63% compared with 61.5% in the Rashkind group (p>0.1). The overall closure rate in the coil group was 72% versus 74.6% for umbrellas.

Conclusion

The outcome in terms of complete duct closure using the Cook coil is comparable with figures obtained using the Rashkind umbrella. Both devices have a good safety profile in the short and medium terms.

Keywords

Patent Ductus Arteriosus Complete Occlusion Transcatheter Closure Occlusion Rate Residual Shunt 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
This is a preview of subscription content, log in to check access.

References

  1. 1.
    Tynan M. The ductus arteriosus and its closure.N Engl J Med 1993; 329: 1570–3.CrossRefPubMedGoogle Scholar
  2. 2.
    Hosking M, Benson L, Musevve N, Dyck J, Freedom R. Transcatheter occlusion of the persistently patent ductus arteriosus.Circulation 1991; 84; 2313–7.PubMedGoogle Scholar
  3. 3.
    Report of European Registry. Transcatheter occlusion of persistent arterial duct.The Lancet 1992; 340: 1062–6.CrossRefGoogle Scholar
  4. 4.
    Janorkar S, Goh T, Wilkinson J. Transcatheter closure of patent ductus arteriosus with the use of Rashkind occluders and/or Gianturco coils: long-term follow up in 123 patients and special reference to comparison, residual shunts, complications, and technique.Am Heart J 1999; 138: 1176–83.CrossRefPubMedGoogle Scholar
  5. 5.
    Galal O, de Moor M, Fadley F et al. Problems encountered during introduction of Gianturco coils for transcatheter occlusion of the patent arterial duct.Eur Heart J 1997; 18: 625–30.PubMedGoogle Scholar
  6. 6.
    Owada CY, Teitel DF, Moore P. Evaluation of Gianturco coils for closure of large (>3.5mm) patent ductus arteriosus.J Am Coll Cardiol 1997; 30: 1856–62.CrossRefPubMedGoogle Scholar
  7. 7.
    Alwi M, Kang LM, Samion H et al. Transcatheter occlusion of native persistent ductus arteriosus using conventional Gianturco coils.Am J Cardiol 1997; 79: 1430–2.CrossRefPubMedGoogle Scholar
  8. 8.
    Dalvi B, Goyal V, Narula D, Kulkarni H, Ramakantan R. New technique using temporary balloon occlusion for transcatheter closure of patent ductus arteriosus with Gianturco coils.Cathet Cardiovasc Diagn 1997; 41: 62–70.CrossRefPubMedGoogle Scholar
  9. 9.
    Schrader R, Hofstetter R, Fassbender D et al. Transvenous closure of patent ductus arteriosus with Ivalon plugs. Multiccnter experience with a new technique.Invest Radiol 1999; 34: 65–70.CrossRefPubMedGoogle Scholar
  10. 10.
    Masura J, Walsh KP, Thanopoulous B et al. Catheter closure of moderateto large-sized patent ductus arteriosus using the new Amplatzer duct occluder: immediate and short-term results.J Am Coll Cardiol 1998; 31: 878–82.CrossRefPubMedGoogle Scholar
  11. 11.
    Rigby M. Closure of the arterial duct: past, present, and future.Heart 1996; 76: 461–2.CrossRefPubMedGoogle Scholar
  12. 12.
    Cowley CG, Lloyd TR. Interventional cardiac catheterization advances in nonsurgical approaches to congenital heart disease.Curr Opin Pediatr 1999; 11: 425–32.CrossRefPubMedGoogle Scholar
  13. 13.
    Uzun O, Dickinson D, Parsons J, Gibbs JL. Residual and recurrent shunts after implantation of Cook detachable duct occlusion coils.Heart 1998; 79: 220–2.PubMedGoogle Scholar
  14. 14.
    Bermudez-Canete R, Santoro G, Bialkowsky J et al. Patent ductus arteriosus occlusion using detachable coils.Am J Cardiol 1998; 82: 1547–9.CrossRefPubMedGoogle Scholar
  15. 15.
    Singh TP, Morrow WR, Walters JL, Vitale NA, Hakimi M. Coil occlusion versus conventional surgical closure of patent ductus arteriosus.Am J Cardiol 1997; 79: 1283–5.CrossRefPubMedGoogle Scholar
  16. 16.
    Ing FF, Sommer RJ. The snare-assisted technique for transcatheter coil occlusion of moderate to large patent ductus arteriosus: immediate and intermediate results.J Am Coll Cardiol 1999; 33: 1710–8.CrossRefPubMedGoogle Scholar
  17. 17.
    Uzun O, Veldtman GR, Dickinson DF et al. Haemolysis following implantation of duct occlusion coils.Heart 1999; 81: 160–1.PubMedGoogle Scholar
  18. 18.
    Wang LH, Wang JK, Mullins CE. Eradicating acute hemolysis following transcatheter closure of ductus arteriosus by immediate deployment of a second device.Cathet Cardiovasc Diagn 1998; 43: 295–7.CrossRefPubMedGoogle Scholar
  19. 19.
    Evangelista JK, Hijazi ZM, Geggel RL, Oates E, Fulton DR. Effect of multiple coil closure of patent ductus arteriosus on blood flow to the left lung as determined by lung perfusion scans.Am J Cardiol 1997; 80: 242–4.CrossRefPubMedGoogle Scholar
  20. 20.
    Goyal VS, Fulwani MC, Ramakantan R, Kulkarni HL, Dalvi BV. Followup after coil closure of patent ductus arteriosus.Am J Cardiol 1999; 83: 463–6.CrossRefPubMedGoogle Scholar
  21. 21.
    Rao PS, Balfour IC, Chen S. Effectiveness of five-loop coils to occlude patent ductus arteriosus.Am J Cardiol 1997; 80: 1498–501.CrossRefPubMedGoogle Scholar
  22. 22.
    Tometzki AJ, Arnold R, Peart I et al. Transcatheter occlusion of the patent ductus arteriosus with Cook detachable coils.Heart 1996; 76: 531–5.CrossRefPubMedGoogle Scholar
  23. 23.
    El Sisi A, Tofeig M, Arnold R, Peart I, Kitchiner DJ et al. Mechanical occlusion of the patent ductus arteriosus with Jackson coils.Pediatr Cardiol 2001; 22: 29–33.CrossRefPubMedGoogle Scholar

Copyright information

© Springer 2002

Authors and Affiliations

  • M. K. El Mallah
    • 1
  • A. J. Sands
    • 1
  • F. A. Casey
    • 1
  • B. G. Craig
    • 1
  • H. C. Mulholland
    • 1
  1. 1.Department of Paediatric CardiologyRoyal Belfast Hospital for Sick ChildrenNorthern Ireland

Personalised recommendations