Reopening After Successful Coil Occlusion for Patent Ductus Arteriosus

Objectives. This study was performed to determine the frequency of patent ductus arteriosus (PDA) reopening and the factors that may predict reopening after successful coil occlusion. Background. Transcatheter coil occlusion is widely used and accepted method to close PDA. After documented successful coil occlusion, we found PDAs that reopened. We hypothesized that specific factors are involved in those that reopened. Methods. All patients who underwent percutaneous transarterial PD coil occlusion were studied. Successful coil occlusion was documented. PD reopening was determined when Doppler-echocardiography (DE) performed after the procedure was negative for PD flow but at follow-up demonstrated PD shunting. Patients with reopened PD were compared with all other patients in evaluating independent variables. Results. Coil occlusion for PD was attempted in 22 patients. Clinical success was achieved in 20 patients (91%), and DE was negative for PD shunting in 19 patients (90%). At follow-up, five patients demonstrated reopening. The PD minimal diameter was 1.4 ± 0.5 mm (mean ± SD) for the reopened group and 1.2 ± 0.7 mm for the other patients. The PD length was 2.9 ± 1.9 mm for the reopened group and 7.1 ± 3.2 mm for all other patients. All those with type B PD were in the reopened group. When independent variables were compared between groups, only PD length and type B PD predicted reopening (p < 0.05). Conclusions. PD reopening may occur after successful coil occlusion. Short PD length and type B PD are associated with reopening. The dat suggest that in such anatomy, alternative strategies to the current coil occlusion technique should be considered.