Echocardiographic Versus Angiographic Assessment of Patent Arterial Duct in Percutaneous Closure: Towards X-ray Free Duct Occlusion?

How can stretched ductus diameter be predicted from angiographic diameter?

BACKGROUND

An appropriate size of device for patent ductus arteriosus (PDA) could be chosen by a stretched PDA size. We propose prediction of stretched size from intact PDA size.

METHODS

A total of 361 patients was enrolled. Intact size was measured on angiography before closure, and stretched size was the narrowest diameter immediately after device implantation.

RESULTS

The median patient age was 2.8 years. Intact diameter and stretched diameter were 3.6 ± 1.4 mm and 5.1 ± 1.3 mm. The difference and difference ratio were 1.5 ± 0.8 mm and 51.3 ± 38.1% and had negative linear correlations with age (P<0.001). Patients were divided into four groups; < 2 years old (159), 2-15 years old (68), 15 - 40 years old (72), and ≥ 40 years old (62). Among groups, difference and difference ratio were significantly different. Stretched diameter was inferred by the following formulas: stretched diameter = 0.660ⅹintact diameter + 2.791 (<2 years old); = 0.971ⅹintact diameter +0.058ⅹage +1.131 (2-15 years old); = 0.790ⅹintact diameter +2.263 (15 - 40 years old); and = 0.837ⅹintact diameter +1.353ⅹBSA -0.096 (≥40 years old).

CONCLUSIONS

Stretched PDA diameter can be predicted from intact diameter and might be helpful for safe PDA closure especially in small infants.