Closure of large patent ductus arteriosus in renal failure under echocardiographic guidance without use of radiographic contrast media.

Large patent ductus arteriosus with large left-to-right shunt results in heart failure, and if untreated, leads to multiorgan dysfunction. Use of radiographic iodinated contrast media for angiogram during transcatheter duct closure may aggravate preexistent renal dysfunction. Aortogram with contrast media was avoided in a patient with renal failure, and echocardiogram guided deployment of duct occluder device in the cardiac catheterization laboratory for closure of a large duct. This article highlights use of a nitinol-based occluder that employs nonporous polytetrafluoroethylene fabric to aid in instantaneous duct closure.