Persistent ductus arteriosus closure

Introduction

Transcatheter closure of persistent ductus arteriosus (PDA) is considered a “routine” procedure. However, even though more than 90% of PDA can be occluded without great technical difficulty, some PDA may be technically more demanding to the operator. This chapter outlines the most commonly used devices for PDA occlusion and describes technical and procedural details that facilitate procedural success of achieving complete PDA occlusion, while at the same time avoiding procedure- or device-related adverse events. Potential procedural pitfalls are outlined and techniques to deal with procedure-related complications are described.

History

The history of percutaneous closure of PDA dates back to 1967, when Porstmann and colleagues first occluded a PDA using a device that was designed specifically for transcatheter PDA closure 11. Porstmann W, Wierny L, Warnke H. Closure of ductus arteriosus persistens without thoracotomy 2. [Article in German]. Fortschr Geb Rontgenstr Nuklearmed. 1968;109:133-48. Link. Even though this demonstrated the feasibility of percutaneous PDA closure, the procedure itself did not find widespread adoption due to its technical complexity, and the necessity to use large arterial cannulation.

In 1979, Rashkind and Cuaso reported on the use of an umbrella device which attached to the ductus by tiny hooks at the ends...