Dealing with patent ductus arteriosus (PDA) spasm in the cath lab

Introduction: Catheter-closure of the PDA is among the safest interventional cardiac procedures, but rarely, the patent ductus has been found to close intermittently, because of the patent ductus arteriosus (PDA) spasm during the PDA closure by cath.Spasm may result in failure of the procedure, or under-sizing of the device, So it is important to correlating echocardiographic findings with the angiographic measurement.Objective: To present cases of spasm of the patent ductus arteriosus during transcatheter closure which we depended on the echocardiographic measurement to choose the size of the device for PDA closure Cases Relate: Case 1: 11 months old girl was admitted for PDA device closure.Echocardiography showed: PDA 4 mm with left to right shunt Aortic angiography at the beginning of the cath showed that the PDA had completely disappeared, After waiting a few minutes the angiography showed 3mm PDA, It was decided that to close the PDA with amplatzer ADO II occluder device, and successfully closed.Case 2: 16-monthold boy undergoing transcatheter coil occlusion of a patent ductus arteriosus.Ductus arteriosus spontaneous spasm with subsequent relaxation resulted in inadvertent coil embolization.This case report and review of the literature have implications for transcatheter treatment of persistent ductus arteriosus.Conclusion: Correlation the echocardiographic size of the PDA with the angiographic measurement should be taken to avoid device under-sizing when PDA spasm occurs during the catheterization.