Transcatheter Patent Ductus Arteriosus Occlusion with Release Control Coils: Application in the Small Child

We evaluated the immediare and intermediate follow-up results of transcatheter closure of patent ductus artericsus (PDA) using release control coils in 16 consecutive patients weighing < 10 kg (median 7.6 kg, range 4.5 to 10). Single coil was used in 10 (62.5 %) patients and two coils in the others. No coil embolization occurred and procedure-related complications were seen in 3 (18.7%) patients: massive femoral hemorrhage in one in whom no medicine was used, femoral artery thrombosis in the other two, which was responsive to streptokinase treatment. But, the PDA was re-canalized in one and mechanical hemolysis started. This was the only patient in whom second occlusion procedure was performed. Complete occlusion was achieved in 7 patients (43.7%) by angiography. Colored Doppler echocardiography demonstrated 81.2 % (13 patients) complete occlusion the next day, and ı 00 o/o (15 patients) after 6-months follow-up. Flow velocities in left pulmonary artery (LPA) and descending aorta (DAo) were measured every six months. LPA velocity was compared to main pulmonary artery and DAo velocity was compared to ascending aorta at their fina! follow-up and no statistical difference found between them. But, it was found > 2 m/see in three patients in the LPA and in one patient in the DAo during follow-up. Two-diın e n s ion a l echocardiography demonstrated protrusion of the device just in three of these patients. Flow velocity was also high in the last patient. In conclusion, transeatbeter closure of PDA with release control coils is feasible in the smail child. But soıne technical aspects must be taken account during implantation procedure and high f low velocity in the LPA or DAo does not always mean obstruction of the vessel.