Transcatheter Closure of Patent Ductus Arteriosus in Infants: A Retrospective Single-Center Study of Procedural Feasibility, Success, and Early Outcomes

Q: What are the key findings of this study?

Transcatheter PDA closure in infants achieved a 99.6% procedural success rate (238/239) with a 0.4% major complication rate (device embolization) and 2.1% minor complication rate.

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Patent ductus arteriosus (n=239). Intervention: Transcatheter patent ductus arteriosus device closure. Primary outcome: Procedural success (successful deployment of the intended occlusion device with stable position and complete closure or clinically insignificant residual shunt before discharge).

Q: What does this research mean for the field?

Transcatheter patent ductus arteriosus closure in infants achieves high procedural success with a very low rate of early complications. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

Qudsia Riaz; Abdul Malik Sheikh; Asma Kanwal; Kiran Azim; Malik Abid Ali; Faiza Fayyaz

doi:10.47144/phj.v59i5.3364

October 11, 2026Pakistan Heart JournalOpen Access

Transcatheter Closure of Patent Ductus Arteriosus in Infants: A Retrospective Single-Center Study of Procedural Feasibility, Success, and Early Outcomes

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Key result

Transcatheter PDA closure achieves ~100% procedural success in infants with low complication rates.

n=239

Why the study?

Although transcatheter closure has increasingly become the preferred treatment for patent ductus arteriosus in infancy, data on procedural outcomes in infants from developing countries remain limited.

Does transcatheter device closure achieve high procedural success and low short-term complication rates in infants younger than one year with hemodynamically significant patent ductus arteriosus?

Key Points

To evaluate the procedural feasibility, success rate, and early clinical outcomes of transcatheter patent ductus arteriosus (PDA) device closure in infants at a specialized tertiary cardiac center.
Retrospective descriptive study reviewing medical records of infants younger than one year evaluated for transcatheter PDA closure at the Rawalpindi Institute of Cardiology in Pakistan.
Procedures were conducted under general anesthesia using fluoroscopic and transthoracic echocardiographic guidance to assess hemodynamics, guide device deployment, and monitor for immediate complications.
Among 247 evaluated infants, 8 (3.2%) had unfavorable ductal anatomy; device closure was attempted in 239 infants and succeeded in 238, resulting in a 99.6% procedural success rate.
A major complication occurred in 1 patient (0.4%) who experienced device embolization requiring successful percutaneous transcatheter retrieval, while minor complications occurred in 5 patients (2.1%).
No cases of procedure-related mortality, left pulmonary artery stenosis, descending aortic obstruction, or residual shunting were identified prior to discharge within 48 hours.

Study Design

Type

Observational (n=239)

Multicenter

No

Structured PICO

Does transcatheter device closure achieve high procedural success and low short-term complication rates in infants younger than one year with hemodynamically significant patent ductus arteriosus?

P

Population

239 infants (<1 year old, mean age 11.0 months, 61.5% female) in Pakistan with hemodynamically significant patent ductus arteriosus undergoing attempted transcatheter device closure and followed until hospital discharge (within 48 hours).

E

Exposure

Transcatheter PDA device closure performed under general anesthesia using fluoroscopic and echocardiographic guidance, with intravenous heparin (100 units/kg). Devices utilized included conventional PDA occluders (90.8%), ventricular septal defect (VSD) occluders (8.4%), Piccolo devices (0.4%), and Amplatzer Duct Occluder II (ADO II) devices (0.4%), delivered via venous-only (61.9%) or combined venous and arterial (38.1%) access.

O

Outcome

Procedural success, defined as successful deployment of the intended occlusion device with stable device position and complete closure or clinically insignificant residual shunt demonstrated on angiographic and echocardiographic assessment before hospital discharge (within 48 hours).surrogate

This single-center study from Pakistan demonstrates that transcatheter PDA closure in infants younger than one year is highly feasible and safe, achieving a 99.6% procedural success rate with minimal in-hospital complications.

Limitations

Retrospective design susceptible to information bias, incomplete documentation, and missing data for echocardiographic and hemodynamic variables
Single-center study limiting generalizability to other institutions
Extended 11-year study period (2014-2025) introducing temporal bias from changes in device technology, techniques, and operator experience
Lack of consistent detailed catheterization-derived hemodynamic measurements
Missing baseline echocardiographic parameters (LVEDD z-scores and LA/Ao ratios) in a subset of patients
Outcome assessment restricted to the in-hospital and early post-procedural period with no long-term follow-up
Retrospective design introduces possibility of information bias, incomplete documentation, and missing data for certain echocardiographic and hemodynamic variables
Single-center study, which may limit generalizability to institutions with different patient populations, procedural volumes, or operator experience
Extended study period (2014 to 2025) may introduce temporal bias due to advancements in device technology, catheterization techniques, imaging quality, and operator expertise
Lack of systematic long-term follow-up, meaning delayed complications such as vascular obstruction cannot be excluded
Descriptive nature of the study and low frequency of adverse events precluded inferential statistical comparisons and predictor analyses

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Implication

Supports feasibility of transcatheter PDA closure in infants; leaves open need for multicenter prospective validation.

Abstract

Objectives: Patent ductus arteriosus (PDA) is one of the most common congenital heart defects encountered during infancy and may lead to significant hemodynamic compromise if left untreated. Transcatheter closure has increasingly become the preferred treatment modality; however, data regarding procedural outcomes in infants from developing countries remain limited. This study aimed to evaluate the feasibility, procedural success, and short-term outcomes of transcatheter PDA device closure in infants at a tertiary cardiac center. Methodology: This retrospective descriptive study was conducted at the Pediatric Cardiology Department of Rawalpindi Institute of Cardiology, Pakistan. Medical records of infants younger than one year who underwent evaluation for transcatheter PDA closure reviewed. Demographic characteristics, echocardiographic findings, procedural details, device types, procedural success, and early complications were extracted and analyzed. PDA diagnosis and assessment of hemodynamic significance were established using transthoracic echocardiography. All procedures were performed under general anesthesia using fluoroscopic and echocardiographic guidance. Short-term outcomes and complications were assessed during hospitalization and before discharge. Results: A total of 247 infants were evaluated for transcatheter PDA closure. Following angiographic assessment, device closure was not performed in 8 (3.2%) patients because of unfavorable ductal anatomy. Among the remaining 239 infants, successful device closure was achieved in 238 patients, resulting in a procedural success rate of 99.6%. There were 92 (38.5%) males and 147 (61.5%) females. The mean age was 11.0 ± 2.0 months, while the mean body weight was 7.8 ± 1.8 kg. Conventional PDA occluders were used in the majority of patients. One patient (0.4%) experienced device embolization requiring successful percutaneous retrieval and was classified as a major complication. Minor complications occurred in 5 (2.1%) patients and resolved without surgical intervention or residual morbidity. Conclusion: Transcatheter PDA closure in infants demonstrated excellent procedural success and a low frequency of early complications. The findings support the feasibility of this minimally invasive approach in appropriately selected infants when performed in experienced centers.

Discussion

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Cite This Study

Riaz et al. (2026) conducted an observational in Patent ductus arteriosus (n=239). Transcatheter patent ductus arteriosus device closure was evaluated on Procedural success (successful deployment of the intended occlusion device with stable position and complete closure or clinically insignificant residual shunt before discharge). Transcatheter PDA closure in infants achieved a 99.6% procedural success rate (238/239) with a 0.4% major complication rate (device embolization) and 2.1% minor complication rate.

synapsesocial.com/papers/6aee6b6871a75948062208a7 https://doi.org/10.47144/phj.v59i5.3364

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Transcatheter Closure of Patent Ductus Arteriosus in Infants: A Retrospective Single-Center Study of Procedural Feasibility, Success, and Early Outcomes

Key Points

Study Design

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Transcatheter Closure of Patent Ductus Arteriosus in Infants: A Retrospective Single-Center Study of Procedural Feasibility, Success, and Early Outcomes

Key Points

Study Design

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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