Objective: Impaired left lung perfusion has been described after coil occlusion of PDA. This study was conducted to evaluate lung perfusion following PDA closure with three different devices including Amplatzer Duct Occluder (ADO).
Method: Lung perfusion scans were performed in 130 of 360 children after PDA closure, including 41 patients with large PDAs (≥4 mm) using ADO device (Group 1), 49 patients with moderate PDAs (2.5-4 mm) using Cook Detachable coils (Group 2) and 40 patients with small PDA’s (≤2.5mm) using Gianturco coils (Group 3). Variables were examined to predict the risks for reduced left lung perfusion.
Results: Decreased left lung perfusion, defined as <40% of total pulmonary blood flow, was found in 15/41 (%37) in Group 1, 10/49 (%20) in Group 2 and 3/40 (%7) in Group 3 (X2=10.195, p=0.006). In Group 1, multivariate logistic regression analysis revealed that tubular and short ducts were significant risk factors for abnormal left lung perfusion (p=0.032). In Group 2, decreased perfusion was significantly correlated with multiple coils usage (p=0.043) and number of loops deployed at the pulmonary side (p=0.013). 1.5 loops deployed at the pulmonary side in two of three patients with abnormal perfusion was the only finding in Group 3.
Conclusion: Abnormal left lung perfusions were found to be more frequently in patients with moderate to large PDAs after transcatheter closure. It seems to be related to ductal morphology (short and tubular shape) for ADO, multiple coils usage and leaving more loops at the pulmonary side for coils.