The only definitive treatment for PDA is ductal occlusion
If left untreated 50% to 64% of dogs are expected to die within 12 months
Compare and contrast these procedures:
Cost: almost identical
Morbidity: surgical correction involves a thoracotomy with the pain inherent in that procedure and the potential for hemothorax, hydrothorax, pyothorax, and pneumothorax. These complications the authors have not experienced with coil embolization. In children coil embolization is an outpatient procedure and the preferred method of closure.
Mortality: surgical mortality is reported at 8% – 11%; we have experienced no mortality with coil occlusion
Complications: with surgery include all those encountered with a thoracotomy. With coil embolization dislodgement of the coil with embolization of the pulmonary arterial tree or the systemic tree. Pulmonary arterial embolization has been described by most centers and if left in place has never resulted in any long-term sequelae. Angiography performed at 1 year after pulmonary artery embolization reveal not difference in perfusion of either lung. Arterial embolization has been rarely encountered by the authors and necessitated coil extraction. This was accomplished with a snare retrieval device. Hemolysis and recanalization have been reported but not observed by the authors.
Residual flow post correction: we believe similar results occur with both procedures – up to 20%. This appears to be insignificant
From one to 11 coils have been required to close the ductus.
Those cases with pulmonary edema are usually readily controlled with diuretics (furosemide) prior to correction. One week of diuretic therapy is usually sufficient
Cases of reverse PDA cannot be corrected, fulminant right heart failure will develop. Patients with reverse PDA can be treated with hydroxyurea to deal with polycythemia; hydroxyurea suppresses bone marrow production of red blood cells (RBCs).
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