Using Interventional Approach in Teatment of Children with Patent Ductus Arteriosus in Shahid Chamran Hospital in Isfahan

Document Type : Original Article


1 Assistant Professor of Pediatric Cardiology

2 Associate Professor of Pediatric Cardiology,Department of Pediatric Cardiology, School of Medicine, Cardiovascular Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

3 Medical Student. School of Medicine, Cardiovascular Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.


Background and Objective: Patent ductus artriosus (PDA) accounts for 8-10% of congenital heart diseases. Patency of this ductus after birth can induce heart failure or endartritis. For these reasons closing of this duct is suggested by surgical or interventional approaches. The purpose of this study was to evaluate the rate of success of closing PDA by interventional approach in Shahid Chamran hospital in Isfahan University of Medical Science. 
Subjects and Methods: Thirty nine patients (18 male and 21 female) and their PDA was diagnosed by echocardiography were the subjects of this study.
Results: Mean weight of patients was 10.82±6.43 Kg. Mean age of patients was 14.3±11.8 months. In 15 patients coil and in 24 patients Amplatzer used for closing of PDA. In 10 patients Cook coil and in 5 patients Pfm coil were used. Mean size of PDA in narrowest size at the pulmonary artery was 3.2±1.7 mm. The mean time of angiography was 45.3±12.2 min and for fluoroscopy was 8.5±6.3 min. No acute complications such as death, severe bleeding, vessels rupture or arrhythmia were encountered. In addition, no late complications such as stenosis in aorta or pulmonary arteries, migration of devices, fracture or deformity of devices or residual shunt were found.
Conclusion: Our experience in this center showed that interventional approaches for closing of PDA are safe.


1-Phillip Moore MD, MBA, Michael M. Brook MD, Michael A, Heymann MD. Patent Ductus Arteriosus and Aortopulmonary Window In: H.D.Allen, D.J. Driscoll, R.E.Shaddy, T. F. Feltes, Moss and Adams' Heart Disease in Infants, Children, and Adolescents: Including the Fetus and Young Adults, 7th Edition.Wolters Klumer. Lippincott Williams & Wilkins,  Phladelphia (2008), p.683-702.
2-Gittenberger-de Groot AC, Van Ertbruggen I, Moulaert AJMG, et al. The ductus arteriosus in the preterm infant: Histologic and clinical observations. J Pediatr 1980;96:88–93.
3-Heymann MA, Rudolph AM. Control of the ductus arteriosus. Physiol Rev 1975;55:62–78.
4-Danilowicz D, Rudolph AM, Hoffman JI. Delayed closure of the ductus arteriosus in premature infants.Pediatrics 1966;37(1):74–8.
5-Siassi B, Emmanouilides GC, Cleveland RJ, Hirose F. Patent ductus arteriosus complicating prolonged assisted ventilation in respiratory distress syndrome. J Pediatr 1969;74(1):11–9.
6-Kitterman JA, Edmunds LH Jr, Gregory GA, Heymann MA, Tooley WH, Rudolph AM. Patent ducts arteriosus in premature infants. Incidence, relation to pulmonary disease, and management. N Engl J Med 1972;287(10):473–7.
7-Mine K, Ohashi A, Tsuji S, Nakashima J, Hirabayashi M, Kaneko. KB-type natriuretic peptide for assessment of haemodynamically significant patent ductus arteriosus in premature infants. Acta Paediatr. 2013 Aug;102(8):e347-52. doi: 10.1111/apa.12273. Epub 2013 May 10.
8-Le J, Gales MA, Gales BJ.  Acetaminophen for patent ductus arteriosus. Ann Pharmacother. 2015 Feb;49(2):241-6. doi: 10.1177/1060028014557564. Epub 2014 Oct 28.
9-Jones LJ, Craven PD, Attia J, Thakkinstian A, Wright I. Network meta-analysis of indomethacin versus ibuprofen versus placebo for PDA in preterm infants. Arch Dis Child Fetal Neonatal Ed. 2011 Jan;96(1):F45-52. doi: 10.1136/adc.2009.168682. Epub 2010 Sep 27.
10-Mortier E, Ongenae M, Vermassen F, Van Aken J, De Roose J, Van Haesebrouck P, Vandeveire B, Rolly G. Operative closure of patent ductus arteriosus in the neonatal intensive care unit. Acta Chir Belg. 1996 Nov-Dec;96(6):266-8.
11-Mitchell SC, Korones SB, Berendes HW. Congenital heart disease in 56,109 births. Incidence and natural history. Circulation 1971;43(3):323–32.
12-Pas D, Missault L, Hollanders G, Suys B, De Wolf D.Persistent ductus arteriosus in the adult: clinical features and experience with percutaneous closure. Acta Cardiol. 2002 Aug;57(4):275-8.
13-Patel HT, Cao QL, Rhodes J, Hijazi ZM. Long-term outcome of transcatheter coil closure of small to large patent ductus arteriosus. Catheter Cardiovasc Interv 1999;47(4):457–61.
14-Masura J, Tittel P, Gavora P, Podnar T. Long-term outcome of transcatheter patent ductus arteriosus closure using Amplatzer duct occluders. Am Heart J 2006;151(3):755.e7–10.
15-Ghaderian M, Ali Samir M, Azizi Mal Amiri R, Fayezi A, Amraee N. Report of PDA Closur by Nonsurgical Approach in Pediatric Less than 15 Years Old in Emam Khomeini Hospital Ahvaz. Jundishapur Sci Med J 2013;12(4):439-446.
16-Ghaderian M, Merajie M, Mortezaeian H, Aarabi Moghadam MY. When Can We Release the Amplatzer Ductal Occluder (ADO) Safely? J Teh Univ Heart Ctr 2013;8(4):182-186.
17-Rueda Núñez F, Avila Alvarez A, Fernández Trisac JL, Abelleira Pardeiro C. Percutaneous closure of patent ductus arteriosus in preterm infants. Rev Esp Cardiol. 2010 Jun;63(6):740-1.
18-Jaillard S, Larrue B, Rakza T, Magnenant E, Warembourg H, Storme L. Consequences of delayed surgical closure of patent ductus arteriosus in very premature infants. Ann Thorac Surg. 2006 Jan;81(1):231-4.
19-Zhou K, Tang J, Hua Y, Shi X, Wang Y, Qiao L, Wang X, Mu D. [Transcatheter occlusion of patent ductus arteriosus in a preterm infant and review of literatures]. [Article in Chinese]. Zhonghua Er Ke Za Zhi. 2016 Jan;54(1):43-6. doi: 10.3760/cma.j.issn.0578-1310.2016.01.010. (Abstract review).
20-Azhar AS, Abd El-Azim AA, Habib HS. Transcatheter closure of patent ductus arteriosus: Evaluating the effect of the learning curve on the outcome. Ann Pediatr Cardiol. 2009 Jan;2(1):36-40. doi: 10.4103/0974-2069.52804.
21-Parra-Bravo JR1, Cruz-Ramírez A, Toxqui-Terán A, Juan-Martínez E, Chávez-Fernández AA, Lazo-Cárdenas C, Beirana-Palencia L, Estrada-Flores J.[Transcatheter closure of patent ductus arteriosus using the Amplatzer duct occluder in children: initial and one-year results]. Arch Cardiol Mex. 2009 Apr-Jun;79(2):114-20. [Article in Spanish] (Abstract review)
22-Jan SL, Hwang B, Fu YC, Chi CS. Transcatheter closure of a large patent ductus arteriosus in a young child using the Amplatzer duct occluder. Pediatr Cardiol 2005;26(5):703-6.