Echocardiography-guided percutaneous closure of patent ductus arteriosus without arterial access: Feasibility and safety for a new strategy.

OBJECTIVE: To evaluate the feasibility and safety of device closure of patent ductus arteriosus (PDA) using only venous access under echocardiography guidance alone.
 Methods: A total of 102 consecutive pediatric patients underwent transcatheter PDA closure without arterial access, under the guidance of only echocardiography. The patients were followed up by clinical examination, electrocardiogram, and echocardiogram at 1, 3, 6 12, and 24 months.
 Results: Transvenous PDA closure under echocardiographic guidance was successful in 99 (97.1%) patients. There were no acute procedural complications or severe adverse events. The duration ranged from 10 to 65 minutes (median, 21 minutes). Immediate complete closure of PDA was achieved in 87 patients (87.9%), and 100% of the patients were completely closed after 24 h. There were no severe adverse events in the period of 1-24 months (median, 12 months) follow up.
 Conclusion: Transvenous PDA closure without fluoroscopy avoids radiation exposure, contrast agent usage and potential arterial complications. It can be used as an alternative procedure, especially for children.