PERCUTANEOUS CLOSURE OF PATENT DUCTUS ARTERIOSUS; IMPLICATIONS OF THE KRICHENKO CLASSIFICATION

doi:10.21608/azjp.2023.287919

PERCUTANEOUS CLOSURE OF PATENT DUCTUS ARTERIOSUS; IMPLICATIONS OF THE KRICHENKO CLASSIFICATION

Document Type : Original Article

10.21608/azjp.2023.287919

Abstract

Background: Despite the revolutionary changes that occurred in percutaneous Patent Ductus Arteriosus (PDA) closure, the classical angiographic Krichenko classification of PDA remained unchanged and its implications on ductal closure has not been frequently studied.
Aim of the work: To explore the relative incidence of the different types of PDA based on Krichenko classification and to compare percutaneous closure of the classical type A to the other non- A types.
Methods: Retrospective study was conducted on a total of 111 patients who underwent percutaneous closure of PDA in our institution over the period from January 2019 till June 2022.
Results: The study included 53 patients with Krichenko type A PDA (47.7 %) and 58 non –type A PDAs (52 %). Patients with type A seemed to have younger age (p= 0.005) and lower weights (p= 0.007) with relatively larger pulmonary end diameters (p=0.000). Duct Occluder I (DO I) was the most commonly used device in group A, while other devices namely Amplatzer Duct Occluder Additional Size (ADO II AS), Flipper coils and PFM coils were more frequently used in the other types (p= 0.004). Non- A PDA seemed to require higher fluoroscopy time (p= 0.32) and radiation exposure (p= 0.006) but no significant difference was observed in the rate of complications (p=0.184).
Conclusion: Closure of non-A Krichenko classification PDA is safe and feasible using the readily available devices. The procedure may require higher radiological exposure yet no difference is seen in the rate of complications.

Keywords