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Transcatheter embolization of abnormal intrathoracic vessels using coils in the setting of children with congenital heart disease

Published online by Cambridge University Press:  19 August 2008

Jean Pierre Pfammatter ,
Ingrid Luhmer  and
Hans Carlo Kallfelz
Jean Pierre Pfammatter*
Affiliation:
Division of Pediatric Cardiology, Children's Hospital, Hannover Medical School, Hannover, Germany
Ingrid Luhmer
Affiliation:
Division of Pediatric Cardiology, Children's Hospital, Hannover Medical School, Hannover, Germany
Hans Carlo Kallfelz
Affiliation:
Division of Pediatric Cardiology, Children's Hospital, Hannover Medical School, Hannover, Germany
*
Dr Jean Pierre Pfammatter MD Division of Pediatric Cardiology, Children's Hospital, Freiburgstrasse, CH 3010 Berne, Switzerland. Tel: ++41 31 632 2111. Fax: ++41 31 632 9748
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Abstract

Objective

it was the purpose of this retrospective study to assess the efficacy and the rate of complications of transcatheter embolization of abnormal intrathoracic vessels using coils in children with complex congenital heart disease.

Patients and methods

in 17 children (mean age 9.2±5.9 years) with complex congenital heart disease, occlusion by catheter intervention was attempted in 29 abnormal intrathoracic vessels: 13 aorto-pulmonary collaterals, 12 arterio-pulmonary collaterals, 2 systemic arteries supplying pulmonary sequestrations, one central venous connection and a Blalock-Taussig shunt. The mean diameter of the vessels was 4.7 ± 1.6 mm (range 2–8 mm). Steel coils with a helical diameter of three, five or eight mm were used. After selective catheterization of the vessel, they were delivered through a 5 F endhole catheter. The helical diameter of the coils was chosen in order to exceed the inner diameter of the vessel by 10–30%.

Results

as assessed by selective angiography performed 10 minutes or more after release of the coil, 27 of the 29 vessels (93%) were successfully occluded. A mean of 2.6 coils (range 1–11) were necessary for successful occlusion. Complications were encountered during 4 attempts of occlusion (14%). Of a total of 76 coils delivered, 4 coils (5%) secondarily migrated after release from the catheter, mostly to branches of the pulmonary arteries. This complication was seen predominantly in those vessels with the largest diameters. Three of the dislocated coils were left in place as they did not significantly obstruct flow of blood. One coil was retrieved by a basket catheter.

Conclusion

transcatheter embolization of abnormal intrathoracic vessels using coils in children with congenital heart disease is an effective therapy. Potential complications warrant careful evaluation of the indications for these procedures.

Keywords

Aortopulmonary collateralstranscatheter embolizationchildren
Type
Original Articles
Information
Cardiology in the Young , Volume 7 , Issue 3 , July 1997 , pp. 310 - 316
Copyright
Copyright © Cambridge University Press 1997

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