Document Detail


Bioptome-assisted coil occlusion of moderate-large patent ductus arteriosus in infants and small children.
MedLine Citation:
PMID:  15170724     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Coil occlusion of patent ductus arteriosus (PDA), although inexpensive, is technically challenging for the moderate-large ducts in small children. Bioptome assistance allows better control and precision. We describe case selection strategies, technique, immediate and short-term results of bioptome-assisted closure of moderate-large (>/= 3 mm) PDA in 86 infants and children </= 10 kg (age, 18 days to 3 years; median, 8 months; weight, 6.6 +/- 1.9 kg; duct size, 3.6 +/- 0.8 mm; pulmonary artery mean pressures, 33 +/- 12 mm Hg). Patients with PDA > 6 mm (> 4 mm for children under 5 kg) and/or shallow ampullae (by echocardiography) underwent operation (n = 41). Specific technical modifications included use of long sheaths (5.5-8 Fr) for duct delineation and coil delivery, cutting of coils turns (51 patients) to accommodate the coils in the ampulla, and simultaneous delivery of multiple coils (n = 43). As far as possible, coils were deployed entirely in the ampulla. Median fluoroscopy time was 7.3 min (1.2-42 min). Successful deployment was feasible in all (final pulmonary artery mean pressures, 20 +/- 4.6 mm Hg). Coils embolized in 14 (16%) patients (all retrieved). Complete occlusion occurred immediately in 63 patients (73%) and in 77 patients (89%) at 24 hr. Three patients had new gradients in the left pulmonary artery. Follow-up (62 patients; median duration, 13 months) revealed small residual Doppler flows in 11 patients (18%) at the most recent visit. Bioptome-assisted coil occlusion of moderate-large PDA in selected infants and small children is feasible with encouraging results.
Authors:
Raman Krishna Kumar; Sivadasan Radha Anil; Bhava R J Kannan; Ancil Philip; Kothandam Sivakumar
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  62     ISSN:  1522-1946     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2004 Jun 
Date Detail:
Created Date:  2004-06-01     Completed Date:  2004-11-08     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  266-71     Citation Subset:  IM    
Copyright Information:
Copyright 2004 Wiley-Liss, Inc.
Affiliation:
Amrita Institute of Medical Sciences, Kochi, Kerala, India. rkrishnakumar@aimshospital.org
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MeSH Terms
Descriptor/Qualifier:
Blood Flow Velocity / physiology
Child Welfare
Child, Preschool
Coronary Angiography
Coronary Circulation / physiology
Device Removal
Ductus Arteriosus, Patent / diagnosis,  physiopathology,  therapy*
Echocardiography, Doppler, Color
Embolization, Therapeutic / instrumentation*
Equipment Design
Follow-Up Studies
Heart Catheterization
Humans
India
Infant
Infant Welfare
Infant, Newborn
Postoperative Complications / diagnosis,  etiology,  physiopathology
Pulmonary Wedge Pressure / physiology
Severity of Illness Index
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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