Results of patent ductus arteriosus closure during adulthood using different devices

Background: In this study, we present cases of patent ductus arteriosus (PDA) diagnosed during adulthood and closed using different devices. Methods: Patients over 18 years of age who were diagnosed at our clinic or who were referred to our clinic for PDA closure between August 2003 and December 2009 were included in this study. The patent ductus arteriosus closure procedure was performed in 57 patients (14 males, 43 females; mean age 32.1 +/- 15.7 years; range 18 to 69 years). The success rate of the procedure was 100%. A duct occluder was used in 31 patients, a controlled release coil was used in 17 patients and a Gianturco coil was used in nine for PDA closure. Closure was indicated in all patients who had a continuous murmur on auscultation following diagnosis of PDA by transthoracic echocardiography. The closure procedure was accomplished according to the patient's will in cases of a silent PDA where there was no audible murmur. Results: The early total occlusion rate in the catheterization laboratory was 86% (n=49) when all three types of devices were taken into consideration. The total occlusion rate was 98% (n=56) as determined by echocardiographic control performed the day after. Two patients who had more than a trivial residual shunt following closure with controlled-release coils had a second coil applied in the same session to achieve total occlusion. Another patient who had hemolysis as a consequence of a trivial residual shunt following controlled-release coil implantation for PDA closure was taken back to the catheterization laboratory a day later and had a second coil implanted for total occlusion. Coil embolization developed in a patient in whom a Gianturco coil was used. The embolized coil was removed using a snare catheter, and the closure procedure was accomplished successfully with another coil. Conclusion: Patent ductus arteriosus in adulthood, after taking the size into consideration, can be safely closed using duct occluders and coils.