Transcatheter Device Closure of Atrial Septal Defect and Patent Ductus Arteriosus: Single Center Experience from Central India

Background: Transcatheter closure of Atrial Septal Defect (ASD) and Patent Ductus Arteriosus (PDA) are one of the most commonly and widely performed cardiac interventional procedures. With plethora of devices available for the closure of the defects, data regarding outcomes post procedure remains limited and more scarcer in Central India. Hence, the present study was planned to study the outcomes using three different set of brands of devices. Methods: The study was a prospective hospital based single center study including 28 patients of ASD and PDA admitted in a tertiary care hospital in Central India during September 2017 to August 2019 to evaluate the outcomes of transcatheter device closure of these congenital heart defects. Results: The median age of the patients with ASD was 18 years (range 4 52 years) while that with PDA was 8 years (range 1.5 50 years). The mean ASD and PDA diameter was 18.8 6.3 mm (range 10 30 mm) and 6 3.6 mm (range 2 14 mm) respectively. Cocoon Septal Occluder was deployed in 3 cases of ASD while HeartR and Floret ASD Occluder were implanted in 3 and 5 cases of ASD respectively. Cocoon Ductal Occluder was deployed in 6 cases of PDA while HeartR, Cera and Floret PDA Occluder were implanted in 4, 1, and 4 cases of PDA respectively. The implantation success rate of ASD and PDA occluder was 84.6 % and 100 % respectively. Immediate closure rates were 90.9 % for ASD and 86.7 % for PDA which improved to 100 % for both procedures at 1 month follow-up. Only 1 case of inadvertent left atrial appendage rupture leading to cardiac tamponade occurred during ASD closure and ASD closure device was withdrawn in another case. On short and intermediate term follow-up (2 - 24 months), no device related complications were observed. No death occurred in the present study. Conclusion: Transcatheter ASD and PDA device closure is an effective and safe procedure with rare complications which can be prevented by careful patient selection along with meticulous imaging. Performance of all the three employed device brands is almost similar with excellent success rate.