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Transcatheter closure of elongated and pulmonary hypertensive patent arterial duct in infants using Amplatzer vascular plug II

  • Sneha M. Jain (a1), Priya M. Pradhan (a1), Supratim Sen (a1) and Bharat V. Dalvi (a1) (a2)



To evaluate the feasibility, efficacy, and safety of Amplatzer vascular plug II in large and elongated ducts in infants.


Patent arterial duct device closure is technically challenging in infants with large and elongated ducts because Amplatzer duct occluder and Amplatzer duct occluder II have high chances of causing aortic coarctation and left pulmonary artery stenosis, respectively. The Amplatzer vascular plug II being soft with no retention discs on either sides helps in mitigating these problems.


This is a prospective, observational study involving infants with clinical, echocardiographic and angiographic evidence of large left to right shunt. All the children underwent duct closure using Amplatzer vascular plug II.


Eighteen infants qualified for the study. Mean age and weight were 8.63 ± 3.84 months and 6.3 ± 1.7 kg, respectively. The angiographic mean duct diameter at the pulmonary artery end was 4.66 ± 0.92 mm, and the mean duct length was 9.4 ± 2.48 mm. The size of Amplatzer vascular plug II used varied from 6 mm to 10 mm. Technical success was achieved in 16/18 cases. One patient had device embolisation, and in the other, the device was found to be unstable. The ratio of Amplatzer vascular plug II size to the duct diameter was 1.65 ± 0.27, while the ratio of ductal length to device length was 1.48 ± 0.46 in those with successful outcome.


Amplatzer vascular plug II is a safe and effective option in appropriately selected infants with elongated ducts. Diameter and length of Amplatzer vascular plug II vis-a-vis those of the ductus are important determinants of the successful outcome.


Corresponding author

Address for Correspondence: B. V. Dalvi, MD, DM, Glenmark Cardiac Centre, 101/102 Swami Krupa Coop Hsg Scty, D L Vaidya Road, Dadar (W), Mumbai400028, India. Tel: +91 22 24335055; Fax: +91 22 24335058; E-mail:


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1.Backes, CH, Rivera, BK, Bridge, JA, et al. Percutaneous Patent Ductus Arteriosus (PDA) closure during infancy: a meta-analysis. Pediatrics 2017; 139: e20162927
2.El-Said, HG, Bratincsak, A, Foerster, SR, et al. Safety of percutaneous patent ductus arteriosus closure: an unselected multicenter population experience. J Am Heart Assoc Cardiovasc Cerebrovasc Dis 2013; 2: e000424.
3.Schwartz, M, Glatz, AC, Rome, JJ, Gillespie, MJ. The Amplatzer vascular plug and Amplatzer vascular plug II for vascular occlusion procedures in 50 patients with congenital cardiovascular disease. Catheter Cardiovasc Interv 2010; 76: 411417.
4.Jang, GY, Son, CS, Lee, JW, Lee, JY, Kim, SJ. Complications after transcatheter closure of patent ductus arteriosus. J Korean Med Sci 2007; 22: 484490.
5.Baspinar, O, Irdem, A, Sivasli, E, et al. Comparison of the efficacy of different-sized Amplatzer duct occluders (I, II, and II AS) in children weighing less than 10 kg. Pediatr Cardiol 2013; 34: 8894.
6.Masura, J, Tittel, P, Gavora, P, Podnar, T. Long-term outcome of transcatheter patent ductus arteriosus closure using Amplatzer duct occluders. Am Heart J 2006; 151: 755.e7755.e10.
7.Duke, C, Chan, KC. Aortic obstruction caused by device occlusion of patent arterial duct. Heart 1999; 82: 109111.
8.Pass, RH, Hijazi, ZM, Hsu, DT, Lewis, V, Hellenbrand, WE. Multicenter USA Amplatzer patent ductus arteriosus occlusion device trial. Initial and one-year results. J Am Coll Cardiol 2004; 44: 513519.
9.Sen, S, Jain, S, Dalvi, B. Embolization of ceramic coated PDA devices into the descending thoracic aorta: probable mechanisms and retrieval strategies. Cardiol Young 2019; 29: 842844.
10.Pepeta, L, Dippenaar, A. Ductal closure using the Amplatzer duct occluder type two: experience in Port Elizabeth hospital complex, South Africa: cardiovascular topic. Cardiovasc J Afr 2013; 24: 202207.
11.Thanopoulos, B, Eleftherakis, N, Tzannos, K, Stefanadis, C. Transcatheter closure of the patent ductus arteriosus using the new Amplatzer duct occluder: initial clinical applications in children. Am Heart J 2008; 156: 917.e1917.e6.
12.Sant’Anna, LOC, da Costa, RN, Ribeiro, MS, et al. Percutaneous occlusion of patent ductus arteriosus with the Amplatzer® vascular plug II device: early experience in three reference centers. Rev Bras de Cardiol Invasiva 2012; 20: 191198.
13.Delaney, JW, Fletcher, SE. Patent ductus arteriosus closure using the Amplatzer® vascular plug II for all anatomic variants. Catheter Cardiovasc Interv 2013; 81: 820824.
14.Garay, FJ, Aguirre, D, Cardenas, L, Springmuller, D, Heusser, F. Use of the Amplatzer vascular plug II device to occlude different types of patent ductus arteriosus in pediatric patients. J Int Cardiol 2015; 28: 198204.
15.VanLoozen, D, Sandoval, JP, Delaney, JW, et al. Use of Amplatzer vascular plugs and Amplatzer duct occluder II additional sizes for occlusion of patent ductus arteriosus: a multiinstitutional study. Cathet Cardiovasc Intervent 2018; 92: 13231328.
16.Krichenko, A, Benson, LN, Burrows, P, Moes, CAF, McLaughlin, P, Freedom, RM. Angiographic classification of the isolated, persistently patent ductus arteriosus and implications for percutaneous catheter occlusion. Am J Cardiol 1989; 63: 877880.
17.Barwad, P, Ramakrishnan, S, Kothari, SS, et al. Amplatzer vascular plugs in congenital cardiovascular malformations. Ann Pediatr Cardiol 2013; 6: 132140.


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Transcatheter closure of elongated and pulmonary hypertensive patent arterial duct in infants using Amplatzer vascular plug II

  • Sneha M. Jain (a1), Priya M. Pradhan (a1), Supratim Sen (a1) and Bharat V. Dalvi (a1) (a2)


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