PATENT DUCTUS ARTERIOSUS DEVICE OCCLUSION IN YOUNG CHILDREN LESS THAN 12 KG- IMMEDIATE RESULTS AND COMPLICATIONS

Abstract

Objective: To assess the immediate results and complications of transcatheter
closure of patent ductus arteriosus (PDA) in young children less than 12kg of
weight.
Methodology: This descriptive cross-sectional study was conducted at
department of Paediatric Cardiology, Chaudhry Pervaiz Elahi Institute of
Cardiology, Multan from September 2009 to October 2013. Patients who under
went PDA closure for moderate to large PDA with LV volume overload without
severe pulmonary hypertension who were <12kg were included. Pre and Post
Procedure Echocardiography was performed. Complications of procedure
including mortality were recorded.
Results: A total of 123 patients underwent PDA occlusion of which 44 (36%)
patients were <12kg. Mean age was 2±1.034 and weight was 9.5kg ± 1.88.
Procedure was successful in all patients without any mortality or major
complications. Small residual PDA in Cath Lab was present in 03 (6.8%), which
resolved in 24 hours. Loss of arterial pulse was present in 08(18%) patients
which recovered within 24 hours with heparin infusion. Protrusion of aortic end
of device without aortic obstruction was present in 10(23%) patients. Partial LPA
obstruction due to device (Echo gradient between 15-30mmHg) was present in
04(09%) patients. There was no device embolization.
Conclusion: Percutaneous closure of moderate to large PDA in young children
weight less than 12kg is a safe procedure without major complications. Loss of
arterial pulse, protrusion of aortic end of device without aortic obstruction,
partial LPA occlusion and residual PDA were the common immediate post device
implantation complications.