Comparison and results of transcatheter closure of patent ductus arteriosus using the swivel-disk device versus plug occluder in children. 
The transcatheter closure of certain types of patent ductus arteriosus (PDA) remains a challenge.  The investigators report initial clinical experience with 25 patients who underwent PDA occlusion with the use of a swivel-disk device (SDD) or a plug occluder (PO).  The patients were divided into 2 groups: in the SDD group, 12 patients aged 1 to 2 years with type A PDA underwent attempted closure using the SDD, a modified Amplatzer duct occluder with a very low profile retention disk that can adapt itself at different PDA insertion angles.  The mean PDA diameter was 4.8 +/- 1.5 mm (range 3.8 to 8).  In the PO group, 13 patients aged 0.5 to 3 years with type C, D, or E PDA underwent attempted occlusion with the PO, a tubular occluder made of Nitinol wire mesh.  The mean PDA diameter was 4.2 +/- 3.5 mm (range 1.2 to 9).  The 2 occluders are filled with Dacron patches.  The mean device diameters were 6.5 +/- 1.2 and 6.8 +/- 2.2 mm (range 4 to 11) in the SDD and PO groups, respectively.  Complete angiographic closure was seen in 24 of 25 patients.  The deployment of 4 5-PDA5 coils abolished a residual shunt associated with hemolysis in a 5-month-old patient with a large type C PDA after the implantation of an 11-mm PO.  No other complications were observed.  In conclusion, the SDD and the PO are promising additions to the armamentarium for PDA closure.