Clinical Outcomes After Percutaneous Patent Ductus Arteriosus Closure in Adults

Can J Cardiol. 2020 Jun;36(6):837-843. doi: 10.1016/j.cjca.2019.11.025. Epub 2019 Nov 27.

Abstract

Background: There is little published data regarding percutaneous patent ductus arteriosus (PDA) closure in adults. We aim to describe the outcomes of adult patients undergoing PDA closure at a single tertiary referral centre.

Methods: All adults who underwent device PDA closure at our centre from 2001 to 2017 were identified and enrolled in the study. Available clinical data and imaging data were reviewed.

Results: At total of 141 patients were identified, with a mean age of 43 ± 15 years. Left ventricular dilation was present in 27% and pulmonary hypertension in 36% of the patients. Most ducts (74%) were of type A morphology. Mean ductal diameter at the pulmonary artery end was 4.1 ± 1.9 mm and mean length was 10.0 ± 4.7 mm. Wire passage from the pulmonary artery was achieved in 79%. Procedural success rate was 100%, and an Amplatzer duct occluder was deployed in all successful cases (ADO1 device in 97%). There was a small residual shunt in 6% at the time of closure, and only 2 patients had a residual leak on echocardiography at a median 3 months' follow-up. No major complications occurred.

Conclusions: Transcatheter PDA closure with the use of an Amplatzer duct occluder is very effective in adults across all duct morphologies and associated with a very low complication rate.

MeSH terms

  • Adult
  • Canada
  • Cardiac Catheterization / methods
  • Cardiovascular Surgical Procedures* / adverse effects
  • Cardiovascular Surgical Procedures* / methods
  • Ductus Arteriosus, Patent* / complications
  • Ductus Arteriosus, Patent* / epidemiology
  • Ductus Arteriosus, Patent* / physiopathology
  • Ductus Arteriosus, Patent* / surgery
  • Echocardiography / methods
  • Female
  • Heart Ventricles* / diagnostic imaging
  • Heart Ventricles* / pathology
  • Heart Ventricles* / physiopathology
  • Humans
  • Hypertension, Pulmonary* / diagnosis
  • Hypertension, Pulmonary* / epidemiology
  • Hypertension, Pulmonary* / etiology
  • Male
  • Organ Size
  • Postoperative Complications* / diagnosis
  • Postoperative Complications* / epidemiology
  • Prosthesis Implantation* / adverse effects
  • Prosthesis Implantation* / instrumentation
  • Prosthesis Implantation* / methods
  • Retrospective Studies
  • Septal Occluder Device*
  • Treatment Outcome