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Transcatheter device closure of patent ductus arteriosus by exclusive venous access under echocardiographic guidance without angiography

Part of: Interventional Cardiology

Published online by Cambridge University Press:  26 April 2021

Salem Deraz Open the ORCID record for Salem Deraz [Opens in a new window] ,
Mohamed Tawfik ,
Susy Kotit  and
Abdelrahman Elafifi
Salem Deraz*
Affiliation:
Aswan Heart Centre, Aswan, Egypt Faculty of Medicine, Menoufia University, Shebin El-Koum, Egypt
Mohamed Tawfik
Affiliation:
Aswan Heart Centre, Aswan, Egypt Faculty of Medicine, Menoufia University, Shebin El-Koum, Egypt Faculty of Medicine, Suez Canal University, Ismailia, Egypt
Susy Kotit
Affiliation:
Aswan Heart Centre, Aswan, Egypt
Abdelrahman Elafifi
Affiliation:
Aswan Heart Centre, Aswan, Egypt
*
Author for correspondence: Salem Elsayed Deraz. E-mail: drsderaz@hotmail.com, Mobile: +201001061905.
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Abstract

Introduction:

The standard transcatheter technique to profile the patent ductus arteriosus requires arterial access through the femoral artery and is associated with arterial complications, longer fluoroscopic time, contrast volume, and longer hospital stay.

Aim of the study:

To compare exclusive transvenous access with the standard procedures for patent ductus arteriosus closure and evaluate whether exclusive venous approach is a safe and effective alternative.

Methods:

A total of 320 patients were included. A detailed echocardiographic evaluation of the duct morphology was performed. Patients were classified into group 1 included patients who underwent exclusive femoral venous access, without any injections of contrast media and group 2 included patients who underwent arterial and venous access.

Results:

Arterial access was achieved in 210 (65.6%). Successful closure of patent ductus arteriosus was achieved in 109 (99.1%) patients in group 1 and in 203 (96.7%) patients in group 2. The patent ductus arteriosus was large and was referred for surgical closure in one patient from group 1 and 7 patients from group 2. Residual patent ductus arteriosus was seen in 6 cases from group 1 (5.4%) and 12 patients from group 2 (5.7%). None of the cases in group 1 had vascular complications, while vascular complications were seen in 20 cases, all of them in group 2 (9.5%). Nonvascular complications were seen in one patient from group 1 (0.9%) and 15 patients in group 2 (7.1%). The procedure time and fluoroscopy times were less in patients with exclusive transvenous access.

Conclusion:

Patent ductus arteriosus device closure without arterial access can be accomplished safely and effectively.

Keywords

Trans-catheterpatent ductus arteriosusechocardiography
Type
Original Article
Information
Cardiology in the Young , Volume 32 , Issue 1 , January 2022 , pp. 55 - 59
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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