Journal of JCIC

The device protrusion into the aorta is one of serious complications in children, especially small infants, who undergo transcatheter device closure of patent ductus arteriosus (PDA). We present the case of a girl with PDA in whom a PDA device protruding into the aorta was successfully reshaped by balloon dilatation. A 9-month-old girl weighing 6.8 kg who had failure to thrive was referred to our hospital for percutaneous PDA closure. Echocardiography showed a large conical PDA measuring 6.0 mm at its narrowest diameter. As aortography showed a Krichenko A type PDA with the pulmonary and Aortic side diameter of 4.9 mm and 13.9 mm respectively, we deployed Amplatzer™ Duct Occluder (ADO) 10/8 from the pulmonary side. However, it migrated into the main pulmonary artery before releasing. Subsequently, an ADO 12/10 was placed in the PDA. As it was oversized, retention skirt seemed to be inadequately deployed and protruded toward the aorta. Balloon dilatation with Tyshak II 12 mm×3 cm was performed on the aortic side of the device, which resulted in better shape of the retention skirt and improved device protrusion toward the aorta. Balloon dilatation can be a feasible procedure to reshape the device protruding into the aorta in infants who undergo transcatheter device closure of PDA.