Transcatheter closure of patent ductus arteriosus

Case contributed by Vincent Tatco
Diagnosis certain


History of patent ductus arteriosus (PDA), which was confirmed by echocardiography. She was brought to the cardiac catheterization laboratory for catheter closure of PDA.

Patient Data

Age: 5 years
Gender: Female

A 5Fr Judkins Right 4 (JR4) catheter was used for right heart cardiac catheterization while a 5Fr pigtail catheter was placed in the descending aorta. Descending aortogram in the lateral and 30 degree right anterior oblique (RAO) projections were taken to identify the patent ductus arteriosus (PDA). The PDA measures 1.6 mm at its narrowest diameter. The PDA was then cannulated retrogradely. A Cook embolization coil was then deployed across the PDA. Post-implantation aortogram revealed a well-positioned PDA coil occluder across the PDA. There was no residual shunt.

Follow-up chest radiograph shows the following findings:

The PDA closure device (coil) is seen in place at the region of the aortopulmonary window. 

Lungs are essentially clear.  Pulmonary vascularity is within normal limits. 

The heart is not enlarged.

Diaphragm and costophrenic sulci are intact.

Bony thorax is unremarkable.

Case Discussion

This case demonstrates a technique of transcatheter coil occlusion of patent ductus arteriosus (PDA) and the radiographic appearance of the device used. There are numerous medical devices that can be seen on chest radiographs, and an embolization coil is one of the many devices that can be used to close PDAs.

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