Transcatheter Patent Ductus Arteriosus Closure: What Have We Learned After Over 25 Years? A Single-Center Experience With 1036 Patients

BACKGROUND Transcatheter patent ductus arteriosus (PDA) closure has become the first-choice method of treatment in the majority of patients. However, device selection poses a challenge.AIMS This study aimed to analyze periprocedural and 1-year outcomes of PDA transcatheter closure performed with different devices throughout a 25-year time period in a single center.METHODS All 1036 patients who underwent transcatheter PDA closure between 1993 and 2020 were included in retrospective analysis. Various devices were used: the Rashkind device ( RD; n = 25), coils (n = 469), nitinol duct occluders type I (DO I; n = 300), type II (n = 32), type II additional sizes (ADO II AS; n = 209), as well as off-label devices: vascular plugs and atrial septal and muscular ventricular septal defect occluders (n = 17). Data on 24-hour and 1-year follow-up were available for 100% and 78.9% of the study patients, respectively.RESULTS The procedure was successful in 98.6% of the study patients, with a major complication rate of 0.2%. Complete PDA closure after a year was observed in 81.8% of the patients treated with RD, 93.7% of those with coils, and 100% of those with duct occluders. There were no differences between Amplatzer DO I (n = 159) and its DO I copies manufactured in China (n = 141) with regard to success, efficacy, and complication rates. Recently, ADO II AS has replaced coils and become the preferred device to close small-to-moderate PDA.CONCLUSIONS Transcatheter PDA closure with all types of nitinol duct occluders is safe and effective, with no residual shunting at 1-year follow-up. Due to higher efficacy, ADO II AS has replaced coils in the treatment of smaller PDA.