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

Published online by Cambridge University Press:  30 January 2020

Sneha M. Jain Open the ORCID record for Sneha M. Jain [Opens in a new window] ,
Priya M. Pradhan ,
Supratim Sen  and
Bharat V. Dalvi
Sneha M. Jain
Affiliation:
Department of Cardiology, SRCC Children’s Hospital, Mumbai, India
Priya M. Pradhan
Affiliation:
Department of Cardiology, SRCC Children’s Hospital, Mumbai, India
Supratim Sen
Affiliation:
Department of Cardiology, SRCC Children’s Hospital, Mumbai, India
Bharat V. Dalvi*
Affiliation:
Department of Cardiology, SRCC Children’s Hospital, Mumbai, India Glenmark Cardiac Centre, Mumbai, India
*
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: bharatdalvi@hotmail.com
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Abstract

Objective:

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

Introduction:

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.

Method:

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.

Results:

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.

Conclusions:

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.

Keywords

Device closureCHDleft to right shunts
Type
Original Article
Information
Cardiology in the Young , Volume 30 , Issue 2 , February 2020 , pp. 243 - 248
Copyright
© Cambridge University Press 2020

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