Transcatheter closure of patent ductus arteriosus among native high-altitude habitants.
Increased prevalence of patent ductus arteriosus (PDA) at high altitude (HA) is a known occurrence. Transcatheter treatment of patients with PDA living at a HA is assessed in this study. Thirteen consecutive patients (all habitants of La Paz, Bolivia) underwent transcatheter closure of PDA. The minimal diameter of PDA was 5.8 (1.5-11) mm and the mean pulmonary artery pressure was 37 (7-80) mm Hg. In 12 patients, the Amplatzer Duct Occluder (ADO) was used; in one child with PDA with a 1.5-mm diameter, a detachable coil was implanted. All procedures, except for one, were completed successfully. The ADO (diameter: 12/10 mm) implantation failed in one child with pulmonary hypertension because the device could not be properly secured in position in a 6-mm PDA. Subsequent surgery was performed without any complications. No residual shunt after 24 h was observed in any case after treatment. No complications were encountered during the procedure and follow-up of 1.5 (from 0.1 to 2.8) years. PDA in native residents of high land have different physiopathologies and anatomies. ADO appears to be a suitable device for transcatheter occlusion for most such patients. Interventional cardiology in countries with residents at high altitudes can be helpful in addressing this issue.