Transcatheter closure of the arterial duct using the Occlutech PDA occluder.

From March 2013 to April 2015, 16 patients underwent percutaneous arterial duct closure with the new Occlutech PDA occluder. There were 10 females and 6 males. All patients had significant L-to-R shunt with enlarged left ventricle.

At implantation, the mean age was 87 months (median 35 months) and mean weight was 16±11kg (7.2 to 54kg). The procedure was realized under local anaesthesia. Size of the duct was 2.96±0.94mm (range 1.7 to 5.5mm) on angiography. According to Krichenko classification of PDA, ducts were: type A (n=14), Type B (n=1) and type E (n=1). The systolic pulmonary artery pressure was 43±17mmHg (range 24 to 91mmHg). Implantation succeeded in all. Closure was performed by the standard 4/6mm occluder (n=8), the standard 6/8mm occluder (n=3), the standard 5/7mm occluder (n=3), the standard 3.5/ 5mm (n=1) and the standard 8/10mm occluder (n=1) using a 6 or 7 F delivery sheath. After implantation, trivial shunt was noticed on angiography in 12 patients, 4 had no shunt. The fluoroscopic time was 6.5±8.7 minutes and radiation dose 6.0±4 Gycm2. After closure, femoral thrombosis was noticed in 2 patients but resolved completely under heparin therapy. On control Doppler echocardiography (1 to 18 months), duct was closed in all patients but one with only one month follow-up. No obstruction of the left pulmonary artery or isthmic stenosis was noticed.

Percutaneous closure of PDA with the new Occlutech PDA occluder is safe and effective. The device is easy to handle and there is no learning curve for operators using the classic Amplatzer duct occluder.

Further studies with longer follow-up are necessary to confirm these good results.