Clinical evaluation of catheter closure of patent ductus arteriosus by Chinese-made mushroom-shape occluder in adults

AIM: To evaluate the treatment efficiency of catheter closure of patent ductus arteriosus (PDA) by Chinese-made mushroom-shape occluder in adults. METHODS: A total of 156 adults with PDA (54 males and 102 females) underwent attempted catheter closure by Chinese-made mushroom-shape occluder. Pulmonary arterial pressure, aortic pressure and oxygen saturation were measured. Aortography showed that the mean PDA diameter of the narrowest segment was (5.2±4.9) mm (range: 1.5-18.2 mm). Lateral descending aortographies were performed to evaluate the immediate results 30 min after the procedure. Follow-up evaluation was performed with color flow mapping at 24 h, 1 month, 3 months, 6 months and 1 year after closure. RESULTS: The devices were successfully placed in 152 patients (with the exception of four patients due to obstructive pulmonary hypertension). Thirty minutes after closure, systolic pulmonary pressure in the successful cases decreased from (48.2±22.6) to (35.6±12.4) mmHg (P<0.05), the mean pulmonary pressure decreased from (40.2±14.5) mmHg to (27.2±10.7) mmHg (P<0.05) and aortic pressure increased from (102.2±12.6) to (106.6±13.8) mmHg (P>0.05). Complete angiographic closure was seen 30 min after placement of device in 119/152 patients (78.3%), whereas small leaks were observed in 33 cases (21.7%). Complete echocardiographic closure was observed in 147/152 successful cases (96.7%) within 24 h and 100% at 1-month follow-up in all patients. There was no PDA recanalization, migration of devices or other complications after complete occlusion during 1-12 months of follow up. CONCLUSION: Catheter closure of adult PDA using Chinese-made mushroom-shape occluder is a safe and effective method used before the occurrence of obstructive pulmonary hypertension.