Percutaneous closure of the small patent ductus arteriosus using occluding spring coils

Division of Cardiology, Children's Hospital-San Diego, California 92123.

OBJECTIVES. This report summarizes our experience with the use of occluding spring coils to close the small patent ductus arteriosus. BACKGROUND. Several patent ductus arteriosus occluders (most notably the Rashkind device) have been developed and studied. Occluding spring coils have been used to close abnormal vessels and vascular connections. We previously reported the use of occluding spring coils to close the small patent ductus arteriosus in a small group of patients. This report describes our series of patients having patent ductus arteriosus closure with occluding spring coils. METHODS. Between June 1990 and June 1993, 30 patients underwent cardiac catheterization to have patent ductus arteriosus closure by occluding spring coils. Selection criteria were age > 6 months and narrowest patent ductus arteriosus internal dimension < or = 3.0 mm by color flow imaging. Definitive selection was based on review of aortograms performed at catheterization. A 5.2F coronary catheter was used to deliver one or two standard occluding spring coils. A loop was delivered in the main pulmonary artery, and the remainder of the coil was delivered across the patent ductus arteriosus and into the aortic diverticulum. Patent ductus arteriosus closure was confirmed by aortography or color flow imaging, or both. Follow-up after coil placement occurred at 6 weeks and 6 months and included two-view chest radiography, echocardiography and color flow imaging. RESULTS. Of the 30 patients, 29 had successful implantation by one (27 patients) or two (2 patients) occluding spring coils. Of these 29 patients, 19 had a clinically apparent and 10 had a silent patent ductus arteriosus. Average ductus minimal internal dimension was 1.7 mm (range 1.0 to 3.0). Complete closure of the ductus was confirmed in 27 patients by aortography or color flow imaging or both (in 24 within 4 h, in 2 after 6 weeks and in 1 after 6 months). Six weeks after implantation, two patients had a tiny residual patent ductus arteriosus noted on color flow imaging. One patient did not have successful implantation. This patient had a 3.2-mm ductus, and two coils migrated to the distal left pulmonary artery and could not be retrieved. There were no deaths or any significant complications noted during early or late follow-up in these patients. CONCLUSIONS. Occluding spring coils may have additional application in closing the small patent ductus arteriosus.

This article has been cited by other articles:

				C. Zabal, J. A. Garcia-Montes, A. Buendia-Hernandez, J. Calderon-Colmenero, E. Patino-Bahena, A. Juanico-Enriquez, and F. Attie Percutaneous closure of hypertensive ductus arteriosus Heart, April 1, 2010; 96(8): 625 - 629. [Abstract] [Full Text] [PDF]

				C. A. Warnes, R. G. Williams, T. M. Bashore, J. S. Child, H. M. Connolly, J. A. Dearani, P. del Nido, J. W. Fasules, T. P. Graham Jr, Z. M. Hijazi, et al. ACC/AHA 2008 Guidelines for the Management of Adults With Congenital Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease) Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons J. Am. Coll. Cardiol., December 2, 2008; 52(23): e143 - e263. [Full Text] [PDF]

				C. A. Warnes, R. G. Williams, T. M. Bashore, J. S. Child, H. M. Connolly, J. A. Dearani, P. del Nido, J. W. Fasules, T. P. Graham Jr, Z. M. Hijazi, et al. ACC/AHA 2008 Guidelines for the Management of Adults With Congenital Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease): Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons Circulation, December 2, 2008; 118(23): e714 - e833. [Full Text] [PDF]

				G Butera, G De Rosa, M Chessa, L Piazza, A Delogu, A Frigiola, and M Carminati Transcatheter closure of persistent ductus arteriosus with the Amplatzer duct occluder in very young symptomatic children Heart, December 1, 2004; 90(12): 1467 - 1470. [Abstract] [Full Text] [PDF]

				R. H. Pass, Z. Hijazi, D. T. Hsu, V. Lewis, and W. E. Hellenbrand Multicenter USA amplatzer patent ductus arteriosus occlusion device trial: Initial and one-year results J. Am. Coll. Cardiol., August 4, 2004; 44(3): 513 - 519. [Abstract] [Full Text] [PDF]

				U. Aydogan, G. Batmaz, and T. Tansel Iatrogenic Coarctation After Coil Occlusion of Arterial Duct Asian Cardiovasc Thorac Ann, March 1, 2002; 10(1): 72 - 74. [Abstract] [Full Text] [PDF]

				M. H. Nezafati, S. H. Hashemian, E. Mahmoodi, and A. Hamedanchi Video-Assisted Thoracoscopic Surgical Closure of Patent Ductus Arteriosus: 300 Cases Asian Cardiovasc Thorac Ann, December 1, 2001; 9(4): 275 - 278. [Abstract] [Full Text] [PDF]

				P.-C. Lee, Z.-C. Weng, Y.-C. Fu, H.-P. Hsing, J.-H. Lu, W.-H. Hsieh, S.-L. Jan, C. C. L. Meng, and B. Hwang Comparison of the One-and-a-Half-Year Results of Closure of Patent Ductus Arteriosus by Transcatheter Coils Placement with Surgical Ligation Angiology, September 1, 2000; 51(9): 757 - 763. [Abstract] [PDF]

				B. D. Thanopoulos, F. A. Hakim, A. Hiari, Y. Goussous, E. Basta, A. A. Zarayelyan, and G. S. Tsaousis Further experience with transcatheter closure of the patent ductus arteriosus using the Amplatzer duct occluder J. Am. Coll. Cardiol., March 15, 2000; 35(4): 1016 - 1021. [Abstract] [Full Text] [PDF]

				A. Sreenivas Kumar, A. Kapoor, N. Sinha, M. Shahi, P. K. Goel, S. Radhakrishnan, and S. Srivastava Percutaneous Occlusion of Patent Ductus Arteriosus with Controlled-Release Coil Asian Cardiovasc Thorac Ann, September 1, 1999; 7(3): 204 - 208. [Abstract] [Full Text] [PDF]

				G S Kalra, P K Verma, S Singh, and R Arora Transcatheter closure of ventricular septal defect using detachable steel coil Heart, September 1, 1999; 82(3): 395 - 396. [Abstract] [Full Text] [PDF]

				F. F. Ing and R. J. Sommer The snare-assisted technique for transcatheter coil occlusion of moderate to large patent ductus arteriosus: immediate and intermediate results J. Am. Coll. Cardiol., May 1, 1999; 33(6): 1710 - 1718. [Abstract] [Full Text] [PDF]

				T Ino, K Nishimoto, M Okubo, K Akimoto, K Yabuta, S Kawasaki, Y Hosoda, and M Iwahara Spring coil retraction in coil occlusion of persistent ductus arteriosus Heart, October 1, 1998; 80(4): 327 - 329. [Abstract] [Full Text]

				L. R. Prieto, D. M. DeCamillo, D. J. Konrad, L. Scalet-Longworth, and L. A. Latson Comparison of Cost and Clinical Outcome Between Transcatheter Coil Occlusion and Surgical Closure of Isolated Patent Ductus Arteriosus Pediatrics, June 1, 1998; 101(6): 1020 - 1024. [Abstract] [Full Text] [PDF]

				I. D Sullivan Patent arterial duct: when should it be closed? Arch. Dis. Child., March 1, 1998; 78(3): 285 - 287. [Full Text]

				H. D. Allen, R. H. Beekman III, A. Garson Jr, Z. M. Hijazi, C. Mullins, M. P. O'Laughlin, and K. A. Taubert Pediatric Therapeutic Cardiac Catheterization : A Statement for Healthcare Professionals From the Council on Cardiovascular Disease in the Young, American Heart Association Circulation, February 17, 1998; 97(6): 609 - 625. [Full Text] [PDF]

				O. Galal, R. Nehgme, F. Al-Fadley, M. d. Moor, F. I. Abbag, S. H. Al-Oufi, E. Williams, M. E. Fawzy, and Z. Al-Halees The Role of Surgical Ligation of Patent Ductus Arteriosus in the Era of the Rashkind Device Ann. Thorac. Surg., February 1, 1997; 63(2): 434 - 437. [Abstract] [Full Text]

				J. A. Hawkins, L. L. Minich, L. Y. Tani, J. E. Sturtevant, G. S. Orsmond, and E. C. McGough COST AND EFFICACY OF SURGICAL LIGATION VERSUS TRANSCATHETER COIL OCCLUSION OF PATENT DUCTUS ARTERIOSUS J. Thorac. Cardiovasc. Surg., December 1, 1996; 112(6): 1634 - 1639. [Abstract] [Full Text]

				R. J. Sommer, M. Recto, R. J. Golinko, and R. B. Griepp Transcatheter Coil Occlusion of Surgical Fenestration After Fontan Operation Circulation, August 1, 1996; 94(3): 249 - 252. [Abstract] [Full Text]

				R. P. Burke, G. Wernovsky, M. van der Velde, D. Hansen, and A. R. Castaneda Video-assisted thoracoscopic surgery for congenital heart disease J. Thorac. Cardiovasc. Surg., March 1, 1995; 109(3): 499 - 508. [Abstract] [Full Text]