Percutaneous closure of previously surgical treated arterial ducts.

AIMS: To report our experience and strategies with transcatheter closure of residual patent ductus arteriousus (RPDA) in patients with previous surgical ligation.

METHODS AND RESULTS: Transcatheter closure of residual patent ductus arteriousus after surgical ligation was attempted in 19 patients. In 13 patients the residual patent ductus arteriosus was closed with detachable coils, in four with Rashkind umbrella and in two with Amplatzer occluder. In order to cross the recanalised duct with the delivery system a vascular loop was required in six patients. Complete closure of residual ducts were achieved in all but one patient.

CONCLUSION: Transcatheter closure appears to be a safe and effective treatment for residual persistent duct. Coil implantation seems to be the best option in the case of smaller ducts, and in larger ones the Amplatzer Duct Occluder appears to be superior. Taking a meticulous approach to choosing the correct device should prevent ineffective treatment.