Transcatheter vs. surgical closure of patent ductus arteriosus: outcomes and cost analysis

  • Mulyadi M Djer Department of Child Health, University of Indon esia Medical School/ Cipto Mangunkusumo
  • Mochammading Mochammading Department of Child Health, University of Indon esia Medical School/ Cipto Mangunkusumo
  • Mardjanis Said Department of Child Health, University of Indon esia Medical School/ Cipto Mangunkusumo
Keywords: persistent ductus arteriosus, Amplatzer® duct occluder, surgical ligation, cost analysis

Abstract

Background Patent ductus arterious (PDA) is a non-cyanotic
congenital heart disease (CHD) caused by the patency of the
arterial duct after birth. For the last three decades, management
of PDA with transcatheter closure has been gaining popularity,
including in developing countries. However its effectiveness in
terms of clinical outcomes and cost may vary among center and
has not been thoroughly evaluated yet in Indonesia.
Objectives To compare the cost and clinical effectiveness of PDA
closure using transcatheter approach compared to surgical ligation.
Methods We performed a retrospective review on patients
underwent either transcatheter or surgical closure of PDA between
January 2000 and December 2006 in Cipto Mangunkusumo
Hospital,Jakarta, Indonesia. Clinical outcomes as well as cost were
compared using the student T-test and Chi-square for numerical
and categorical variables, respectively
Results During the study period, 89 patients underwent transcatheter
closure using an Amplatzer® device occluder (ADO) device and
67 had surgical ligation. Successful PDA closure on first attempt
was achieved in 87 (96%) and 63 (94%) children who underwent
transcatheter and surgical closure, respectively (P = 1.000). Two
children with unsuccessful transcatheter closure eventually had
their PDA closed by surgery, whereas one child with residual PDA
after surgical closure had his PDA closed by coil. No residual PDA
was found in the transcatheter closure group at one-week follow up.
Duration of hospitalization was significantly less for patients having
transcatheter closure compared to surgery [2.7 (SD 1.5) vs. 6.6 (SD
1.5) days, P< 0.0001]. The cost for PDA closure with anAmplatzer®
device was more expensive than surgical ligation [Rp. 29,930,000 (SD
57,200) vs. Rp. 12,205,000 (SD 89,300), P< 0.0001].
Conclusion Transcatheter closure is equally effective as surgical
ligation in closing the PDA. Less hospitalization is required with
transcatheter closure although the cost is higher than surgical
ligation.

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Published
2013-08-31
How to Cite
1.
Djer M, Mochammading M, Said M. Transcatheter vs. surgical closure of patent ductus arteriosus: outcomes and cost analysis. PI [Internet]. 31Aug.2013 [cited 29Mar.2024];53(4):239-4. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/289
Section
Articles
Received 2016-08-21
Accepted 2016-08-21
Published 2013-08-31