Transcatheter closure of the patent ductus arteriosus at a public sector hospital in Soweto, South Africa: a review of patient outcomes over 15 years

Cardiovasc J Afr. 2018 Jul/Aug;29(4):246-251. doi: 10.5830/CVJA-2018-028.

Abstract

Background: Methods of closing patent ductus arteriosus (PDA) have evolved over time. We review this development in our setting.

Methods: This was a retrospective analysis of children who had transcatheter PDA closure at Chris Hani Baragwanath Hospital between 1993 and 2008.

Results: Over 15 years, 1 254 PDAs were diagnosed, of which 293 required intervention; 139 patients had transcatheter closure, the median age was 1.8 years (interquartile range = 1-4.5 years) and 66% were female (92/139). Mean PDA diameter was 3.2 mm (standard deviation = 1.6 mm), with an average 2:1 shunt. Transcatheter closure was performed using COOK® Flipper coils (n = 93) or Amplatzer devices (n = 46). Early occlusion rates for coils were 52% (39/75) and late occlusion occurred in 91% (68/75) of patients. For Amplatzer devices, early occlusion rates were 94% (33/35) and late occlusion was 100%. Amplatzer devices, available since 2003, were overwhelmingly used in the later years.

Conclusions: Transcatheter PDA closure was safe and effective in this setting, with outcomes similar to reports elsewhere.

Keywords: intervention; percutaneous; transcatheter; patent ductus arteriosus (PDA).

Publication types

  • Comparative Study

MeSH terms

  • Cardiac Catheterization* / adverse effects
  • Cardiac Catheterization* / instrumentation
  • Child, Preschool
  • Ductus Arteriosus, Patent / diagnostic imaging
  • Ductus Arteriosus, Patent / physiopathology
  • Ductus Arteriosus, Patent / therapy*
  • Female
  • Hospitals, Public*
  • Humans
  • Infant
  • Male
  • Prosthesis Design
  • Public Sector*
  • Retrospective Studies
  • Septal Occluder Device
  • South Africa
  • Time Factors
  • Treatment Outcome