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Immediate and early results of closure of moderate to large patent arterial ducts using the new Amplatzer™ device

Published online by Cambridge University Press:  19 August 2008

Ashutosh Marwah ,
S. Radhakrishnan  and
Savitri Shrivastava
Ashutosh Marwah
Affiliation:
Division of Pediatric Cardiology, Escorts Heart Institute and Research Centre, New Delhi, India
S. Radhakrishnan*
Affiliation:
Division of Pediatric Cardiology, Escorts Heart Institute and Research Centre, New Delhi, India
Savitri Shrivastava
Affiliation:
Division of Pediatric Cardiology, Escorts Heart Institute and Research Centre, New Delhi, India
*
Dr S. Radhakrishna, Division of Pediatric Cardiology, Escorts Heart Institute & Research Centre, Okhla Road, New Delhi–110025, India. Tel: 91–11–6825000, 91–11–6825001; Fax: 91–11–6825013; E-mail: Samurai43@yahoo.com
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Abstract

Objective

Our aim was to assess the immediate and short term results of closure of moderate and large patent arterial ducts using the self-expanding and repositionable Amplatzer device.

Method

We attempted closure in 25 patients (10 Females and 15 males) using the Amplatzer occluder. Their median age was 48 months with a range from 8months to 26years and median weight of 14kg with a range from 4.5kg to 48kg. The mean ductal diameter was 4 (S.D 1.51mm). A 6F/7F long sheath was used to deliver the device. Follow up was performed with colour- flow mapping of the pulmonary trunk within 24 hours, at 3 months, and 6 months of closure.

Results

Of the 25 patients, the device was placed successfully in 23. Concurrent angiography showed immediate closure in 12 patients, while 8 had trivial shunting and 3 had mild shunting. Within 24 hours, Doppler examination revealed complete closure in all but three patients, who had a mild residual shunt. Two attempts were unsuccessful. Both these patients underwent successful surgical ligation. All except one patient were discharged on the next day. Of the 23 patients, 15 (65%) have been followed up for 3months, while 8 (35%) have completed 6 months of follow-up. Of the three patients initially with mild residual flow, two had completely closed at 3 months The one remaining patient is yet to be seen at the 3 month follow-up. Thus, at 3 months, all patients studies had shown complete closure.

Conclusion

Antegrade transcatheter closure using the Amplatzer duct occluder is an efficacious treatment for bigger patent arterial ducts. Long-term follow-up is necessary to show sustained benefits and confirm the absence of side effects.

Keywords

Patent arterial ductAmplatzer device
Type
Original Articles
Information
Cardiology in the Young , Volume 10 , Issue 3 , May 2000 , pp. 208 - 211
Copyright
Copyright © Cambridge University Press 2000

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References

1.Wierny, L, Plass, R, Porstmann, W. Transluminal closure of patent ductus arteriosus: long-term results of 208 cases treated without thoracotomy. Cardiovasc intervent Radiol 1986;9:279–285.CrossRefGoogle ScholarPubMed
2.Rashkind, WJ, Mullins, CE, Hellenbrand, WE, Tait, MA. Non-surgical closure of patent ductus arteriosus: clinical application of the Rashkind PDA occluder system. Circulation 1987;75:583–592.CrossRefGoogle Scholar
3.Hosking, MCK, Benson, LN, Musewe, N, Dyck, JD, Freedom, RM. Transcatheter occlusionof the persistantly patent ductus arteriosus: forty-month follow-up and prevalence of residual shunting. Circulation 1991;84:2313–2317.CrossRefGoogle Scholar
4.Latson, LA, Hofchire, PJ, Kugler, JD, Cheatham, JP, Gumbiner, CH, Danford, DA. Transcatheter closure of patent ductus arte riosus in pediatric patients. J Pediatr 1989;115:549–553.CrossRefGoogle Scholar
5.Rao, PS, Sidris, EB, Haded, J, Rey, C, Hausdorf, G, Wilson, AD, Smith, PA, Chopra, PS. Transcatheter occlusion of patent ductus arteriosus with adjustable button device: initial clinical expe rience. Circulation 1993;88:1119–1126.CrossRefGoogle Scholar
6.Verin, YE, Savliev, VS, Kolody, SM, Prokubovski, VI. Results of transcatheter closure of patent ductus arteriosus with Botolloocluder. J Am Coil Cardiol 1993;22:1509–1514.CrossRefGoogle Scholar
7.Moore, JW, George, L, Krikpatrick, SE, Mathewson, JW, Spicer, RL, Uzark, K, Rothman, A, Cambier, PA, Slack, MC, Kiriby, WC. Percutaneous closure of the small patent ductus arteriosus using spring coils. J Am Coil Cardiol 1994;23:759–765.CrossRefGoogle ScholarPubMed
8.Lloyd, TR, Fedderly, R, Mendelshon, AM, Sandhu, SK., Beckman, RH III. Transcatheter occlusion of patent ductus arteriosus using Gianturco coils. Circulation 1993;88:1412–1420.CrossRefGoogle ScholarPubMed
9.Hijazi, ZM, Lloyd, TR, Beckman, RH, Geggle, RL. Transcatheter closure with single or multiple Gianturco coils of patent ductus arteriosus in infants weighing <8 kg : retrograde versus antegrade approach. Am Heart J 1996;132:827–835.CrossRefGoogle ScholarPubMed
10.Hijazi, ZM, Geggle, RL. Results of antegrade transcatheter closure of patent ductus arteriosus using single or multiple Gianturco coils. Circulation 1994;74:925–929.Google ScholarPubMed
11.Masura, J, Walsh, KP, Thanopoulos, B, Chan, C, Bass, J, Goussus, Y, Gavora, P, Hijazi, ZM. Catheter closure of moderate-to large- sized patent ductus arteriosus using the new Amplatzer duct occluder: Immediate and short-term results. J Am CoilCardiol 1998;31:878–882.CrossRefGoogle ScholarPubMed
12.Musewe, NN, Benson, LN, Smallhorn, JF, Freedom, RM. Two- dimensional echocardiographic and color flow Doppler evaluation of the ductal occlusion with the Rashkind prosthesis. Circulation 1989;80:1706–1710.CrossRefGoogle ScholarPubMed
13.Tynan, Mfor the European Registry. Transcatheter occlusion of persistent arterial duct: report of the European Registry. Lancet 1992;340:1062–1066.Google Scholar
14.Ali-Khan, MA, Yousef, SA, Mullins, CE, Sawyer, W. Experience with 205 procedures of transcatheter closure of ductus arteriosus in 182 patients with special reference to residual shunts and long-term follow-up. J Thorac Cardiovasc Surg 1992;104:1721–1727.CrossRefGoogle ScholarPubMed
15.Dessy, H, Hermus, JPS, van den Heuvel, F, Oei, HY, Krenning, EP, Hess, J. Echocardiographic and radionuclide pulmonary blood flow patterns after transcatheter closure of patent ductus arteriosus. Circulation 1996;94:126–129.CrossRefGoogle ScholarPubMed
16.Cambier, PA, Kirby, WC, Wortham, DC, Moore, JW. Percutaneous closure of small (less than 2.5mm) patent ductus arteriosus using coil embolization. Am J Cardiol 1992;69:815–816.CrossRefGoogle Scholar
17.Hijazi, AM, Geggle, RL. Transcatheter closure of patent ductus arteriosus using coils. Am J Cardiol 1997;79:1279–1280.CrossRefGoogle ScholarPubMed
18.Hijazi, AM, Geggle, RL. Transcatheter closure of patent ductus arteriosus (> 4mm) with multiple Gianturco coils: immediate and mid-term results. Heart 1996;76:536–540.CrossRefGoogle Scholar
19.Ino, T, Nishimoto, K, Okubo, M, Akimoto, K, Yabuta, K, Kawasaki, S, Hosoda, Y, Iwahara, M. Spring coil retraction in occlusion of persistent ductus arteriosus. Heart 1998;80:327–339.CrossRefGoogle ScholarPubMed