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Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
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Percutaneous patent ductus arteriosus closure: A 12-year experience
Session:
Posters 1 - Écran 6 - Cardiologia de Intervenção
Speaker:
João Antunes Sarmento
Congress:
CPC 2019
Topic:
H. Interventional Cardiology and Cardiovascular Surgery
Theme:
25. Interventional Cardiology
Subtheme:
25.3 Non-coronary Cardiac Intervention
Session Type:
Posters
FP Number:
---
Authors:
João Antunes Sarmento; Correia-Costa A.; Gonçalves E.; Baptista M.J.; Silva J.C.; Jorge M. Antunes Moreira
Abstract
<p><strong>Introduction:</strong></p> <p>A patent <em>ductus arteriosus</em>(PDA), one of the most common congenital heart defects, results from a failure of normal physiologic closure of the fetal ductus, with a persistent communication between the descending thoracic aorta and the pulmonary artery. Transcatheter occlusion is an effective alternative to surgical intervention and is currently the treatment of choice for most cases of PDA in children and adults. The authors wanted to review the results obtained during a 12-year experience with this technique. </p> <p> </p> <p><strong>Methods:</strong></p> <p>Medical record data of all patients referred for percutaneous PDA closure in a reference center from January 2006 until September 2018 was collected and reviewed retrospectively. Indications for closure were presence of cardiac murmur, left-sided volume overload or heart failure signs. </p> <p> </p> <p><strong>Results:</strong></p> <p>A total of 221 patients were referred for percutaneous PDA closure, with a mean age of 5.5 years-old (16 patients had less than 1 year of life, with the youngest being 4 months-old). A Nit-Occlud<sup>®</sup>coil was used 139 times (62,9%), an AMPLATZER<sup>™ </sup>duct occluder (ADO) was used 79 times (35,75%), and other devices (vascular plugs) were used 3 times. PDA closure was achieved in every treated patient, with residual shunting found in 1,4% of cases. Even though there was higher overall coil device implantation, a higher prevalence of ADO usage was noted since 2011. Of all coil devices used, 55% were either 4x4 or 5x4 mm in size, and of all ADO devices used, 73% were either ADO I 6x4 or 8x6 mm in size, which correlates to the fact that most patients who were referred had small to moderate sized PDA. No complications were noted during the procedure. A post-procedure complication rate of 1,8% was noted, with one case of device embolization 48 hours after the procedure and 3 cases consisting of loss of arterial pulse, being treated successfully with fibrinolytics. No significant differences in complication rates between different devices were noted. </p> <p> </p> <p><strong>Conclusions:</strong></p> <p>Percutaneous PDA closure was safe and effective in this setting, with a low global complication rate and similar outcomes to most equivalent centers.</p>
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