Abstract：Objective This study aimed to reporting the experience in the treatment of cardiac malformation using coil implantation in children. Methods Between February 1995 and January 2004, 133 children (63 males and 70 females, with an age range of 0.8- 13.0 years) with cardiac malformation were referred for closure with coils. The efficacy evaluation was based on: 1) immediate success of the closure as measured by transthoracic echocardiography (TTE); 2) short-, medium-, and long-term follow-up after implantation as assessed by TTE and electrocardiograph; and 3) the incidence of complications. Results A total of 101 patients underwent closure of patent ductus arterious (PDA) using coil implantation. The Gianturco coil was successfully implanted in 14 cases and Duct-Occlud or Nit-Occlud coil in 87 cases. Four patients had 2 coils implantaed. The minimal diameter of PDA was 1.6± 0.6 mm (range 0.5- 3.8 mm). The immediate complete closure rate was 90.1%. This increased to 98.0% and 99.0% at 1 month and 1 year, respectively. The Gianturco coil was used to embolize the collaterals in 14 patients with cyanotic heart diseases. Five patients received 1 coil implantation and the rest had 2-4 coils. The minimal diameter of the collaterals was 3.5± 0.8 mm (range 2.1-5.0 mm). The complete closure rate was 100% at 10-15 minutes after implantation. Fourteen patients with coronary artery fistula, including 8 cases of right coronary artery-right atrial fistula and right coronary artery-right ventricular fistula and 6 cases of left anterior descending and circumflex-right atrial fistula or right ventricular fistula, underwent closure by Gianturco or Duct-Occlud coil implantation. The minimal diameter was 3.8± 1.1 mm (range 2.0- 5.1 mm). Only 1 coil was used in 11 patients, and 2-4 coils in 2 patients. The immediate complete closure rate was 38.5%(5/13), and up to 84.6% (11/13) at 1 month. Unsuccessful deployment of implantation occurred in 1 case with right coronary artery-right ventricular fistula due to the coil movement to distal pulmonary artery trees immediately after embolization. After the coil was successfully retrieved, the patient needed a surgical operation. Two patients with pulmonary arteriovenous fistula received 6 or 16 Gianturco coils implantations respectively. The systemic saturations increased from 76% to 91% and 96% respectively. Two patients underwent closure of perimembranous ventricular septal defect (VSD) with pseudoaneurysm with only 1 Duct-Occlud coil. A minimal residual shunt was seen immediately after closure and disappeared after 24 hrs. A 2 months to 4 years follow-up showed that no complications related to device implantation occurred in any patient. Conclusion Transcatheter closure using coils is safe and effective in selected cases of cardiac malformation in children.
