Minimally Invasive PDA Closure Procedure Using a Transcatheter Occluder

Understanding Patent Ductus Arteriosus (PDA)

Patent Ductus Arteriosus, or PDA, is a heart condition commonly diagnosed in infants and children, where the ductus arteriosus—a blood vessel that connects the pulmonary artery and the aorta—fails to close after birth. If left untreated, it can lead to complications such as heart failure, pulmonary hypertension, or developmental issues. Fortunately, minimally invasive procedures like transcatheter closure have become the preferred treatment method for many patients.

Preparation and Anesthesia

During the procedure, the child is placed under general anesthesia using a combination of intravenous and inhaled agents to ensure comfort and immobility. Once the anesthesia takes effect, the surgical team proceeds with vascular access, typically through the right femoral vein and artery.

Vascular Access and Imaging

Percutaneous puncture of the right femoral vein and artery is performed to introduce the necessary catheters. Aortography is then carried out by injecting contrast dye into the descending aortic arch to obtain a 90-degree left anterior oblique view. This imaging technique allows the cardiologist to precisely determine the location, shape, and size of the PDA, which is crucial for selecting the appropriate occluder device.

Device Delivery and Deployment

Once the measurements are confirmed, a guidewire is advanced through the right heart and across the PDA to establish a delivery track. The occluder device is then carefully guided through the femoral vein into the pulmonary artery side of the PDA. Under continuous fluoroscopic guidance, the device is deployed and released at the optimal position to seal the abnormal connection.

Post-Procedure Care

After successful deployment, pressure is applied to the puncture site for several minutes to prevent bleeding and promote clotting. The anesthesia is gradually discontinued, and the child is closely monitored as they regain consciousness. Once stable, the patient is transferred back to the recovery room for further observation.

Benefits of Transcatheter Closure

Compared to traditional open-heart surgery, this minimally invasive approach offers faster recovery, reduced hospital stay, and minimal scarring. It is especially beneficial for pediatric patients who may be more vulnerable to surgical complications.