Percutaneous device versus surgical closure of patent ductus arteriosus

Abstract

Background: Various devices have employed for percutaneous closure of Patent Ductus Arteriosus (PDA). Although effectiveness of device closure has been determined, a few studies focused on the cost-effectiveness and postoperative complications comparison with open surgery. Purpose: Evaluate of PDA occlusion by Amplatzer Ductal Occluder in comparison with open surgical closure. Method: A reviewed study from medical record in children with PDA whom underwent interventions for three years. The interventions including Amplatzer Ductal Occluder and open surgical closure. Cross sectional analysis from medical record was done. Data of demographic, characteristic PDA, lenght of stay, costs, interventions, outcome, and complication were collected. Difference were analyzed using Mann Whitney test. Result: Eighteen children (4/18 male) were diagnosed with PDA. The median age was 6.0 years, (SD 9.98). Most of patient with moderate PDA (13/18) and large PDA (5/18). Interventions including Amplatzer ductal occluder (9/18) and open surgical closure (9/18). In surgical group have experienced to be cared in ICU during hospitalized (9/18, median 0.5 day, p<0.01). The lenght of stay during hospitalized was longer in surgical group (median 5.5 days, p<0.01). The calculated costs were higher in surgical group median 28.099.500 IDR, p=0.04). No event of mortality was observed in both of group. However in surgical group, one patient experienced pneumonia, and one patient suffered electrolyte abnormality including hypokalemia. Conclusion: Amplatzer Ductal Occluder was more preferable because of its lower inexpensive and complication than surgical technique.

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