Transcatheter closure of patent ductus arteriosus in infants with body weight under 8 kg

Objective: To explore the safety and effectiveness of interventional transcatheter closure of patent ductus arteriosus (PDA) in infants with body weight under 8 kg, and to summarize the clinical experience. Methods: During the period from May 2001 to August 2013, a total of 102 PDA children with body weight �� 8 kg were admitted to the hospital. All patients were underwent transcatheter closure and angiography of the arch and descending aorta was carried out at 6 minutes after the closure procedure. Chest film, ECG and echocardiography were performed at 24 hours, 1 month, 3 months and 6 months after the operation in order to evaluate the clinical therapeutic efficacy. The results were analyzed. Results: Of the 102 PDA patients, funnel type was seen in 58, tubular type in 39, window type in 1 and irregular type in 4. The narrowest diameter at pulmonary artery side of PDA was 2-10 (4.8 �� 1.6) mm. The occluder used in the patients included mushroom occluder produced by Amplatzer company (n = 25), new type Amplatzer ADO-II occluder (n = 5), Amplatzer Plug (n = 1), domestic-made PDA mushroom occluder (n = 69) and domestic-made VSD occluder (n = 2). The waist diameter of the mushroom occluders used in the patients was 6-16 mm. The preoperative mean pulmonary pressure �� 25 mmHg was seen in 87 patients, and �� 50 mmHg in 43 patients. Ten minutes after occlusion, the mean pulmonary pressure decreased to different extent, which was consistent with dynamic pulmonary artery hypertension. Successful treatment was obtained in all patients with a success rate of 100%. Conclusion: For PDA infants with low body weight interventional treatment carries certain risks. However, transcatheter closure is still a safe and effective method for PDA infants when close attention to the sufficient preoperative preparation, careful manipulation, the selection of proper occluder and the prevention of complications are paid.