Objectives: Accurate assessment of size and morphology of patent ductus arteriosus (PDA) is crucial in selecting best device for transcatheter closure. This often can only be achieved by invasive angiography among adult patients because of poor transthoracic echocardiographic windows. We aimed to determine accuracy of multi-slice computed tomography (MSCT) angiography in assessing PDA among adults before transcatheter closure.
Methods: 24 patients (mean age 25.4 ± 1.3 years) with PDA underwent both MSCT and invasive angiography assessment before transcatheter PDA closure. Measurements and determination of morphological type were compared between the two methods.
Results: The mean diameter of PDA was 4.6 ± 2.9 mm (range 1.3 to 12.0 mm) and the morphology types were: Type A (20 patients), Type B (1 patient), Type C (3 patients). Transcatheter PDA closure was successful in 22 patients. Types of devices used were: Amplatzer Duct Occluder 8/6 (9 patients), 10/8 (10 patients) and 16/14 (1 patient), Gianturco coil (1 patient), Amplatzer Muscular VSD Occluder 12 mm (1 patient). The remaining 2 patients had Eisenmenger syndrome. The PDA diameters measured on MSCT correlated highly with measurements by invasive angiography (Pearson correlation coefficient = 0.915, p < 0.001). Morphological classification were concordant in all cases. Type of closure devices used could be correctly predicted by MSCT before the procedure in all cases.
Conclusions: Assessment of PDA in adults by MSCT is accurate in guiding device selection for transcatheter closure.