Successful Transcutaneous Closure of Patent Ductus Arteriosus.
[ Congenital Heart Disease ]

Dr. Bharat Dalvi, Dr. Rita Dixit

Department Of Cardiac Surgery [A Nanavati Hospital ]

P. D. A. is an abnormal communication between the Aorta and the Pulmonary artery which results in the mixing of oxygenated and deoxygenated blood. This communication is present in embryonic life normally closes soon after birth. Unfortunately, the closure does not occur in some children and so it is called Patent Ductus Arteriosus.

A 10 year old female presented to us with history of recurrent chest infections and was found to have a murmur [abnormal heart sound]

Examination revealed a continuous machinery murmur in the 2nd ICS. Chest X-Ray and 2D-Echo were carried out and showed findings consistent with P. D. A.

Her blood investigations were within normal limits. They consulted Dr. Bharat Dalvi who gave them an option of transcutaneous closure of PDA [repair of the heart defect without surgery].

She was optimized and taken up for the procedure. The procedure was done under local anesthesia and lasted for about 1and half hrs.

Catheters [small tubes] were advanced to the area of defect near the heart from her groin [without cut], which contained the AMPLATZER [umbrella] device. These devices are made up of an alloy called NITINOL.

It is a Biocompatible alloy with MEMORY [Takes original shape at body temperature]. These characteristics make it most suitable for the procedure. At the area of the defect the umbrella [device] was delivered in a controlled fashion without damaging the surrounding structures.

The design of the device is such that if the “lie” is sub optimal then , it can be retrieved and repositioned until optimal positioning is obtained.

After the procedure patient was transferred to the ward discharged next day. She was prescribed Baby Aspirin pills for 6 months.

CONCLUSION :
Surgical closure of PDA which involves long cuts and an hospital stay of around 5 days is no longer the only option.

Device closure of congenital cardiac defects are safe efficacious and proved for over 9 years all over the world. Short and intermediate term results are gratifying.