Transcatheter closure of the patent ductus arteriosus using an Amplatzer duct occluder in adults

Contemporary outcomes of percutaneous closure of patent ductus arteriosus in adolescents and adults

Background

Catheter based treatment has gained wide acceptance for management of patent ductus arteriosus (PDA) ever since its introduction. Percutaneous closure in adults can be challenging because of anatomical factors including large sizes, associated pulmonary arterial hypertension (PAH) and co-morbidities. This study aimed to provide comprehensive contemporary data on the safety and efficacy of percutaneous device closure of PDA in adult and adolescent population at a large referral center.

Methods

This single-center retrospective analysis included 70 patients (33 adolescents and 37 adults) who underwent successful percutaneous device closure of PDA between January 2011 and February 2017.Baseline patient demographics, clinical characteristics, procedural and device related variables, and immediate outcomes during hospital stay were recorded. Patients were followed up for residual shunt and complications.

Results

Of 70 PDA device closure cases, 71.4% were females; the mean age was 23 years (range:10-58years). Devices used were 4-Cook’s detachable coils, 64-occluders (ADO-I and II, Lifetech, Cardi-O-Fix), 1-vascular plug and 1-ventricular septal occluder device. Device success was achieved in all including those with very large PDAs. At 24-h post-procedure, the success rate of transcatheter intervention was 95.7%. At 6-months follow up, complete closure was observed in all (mean follow up duration-531 days). In patients with severe PAH, significant immediate and sustained reduction of the mean pulmonary pressure was observed(77 mmHg to 33 mmHg;P = 0.014). No procedure-related complications including death, device embolization and stenosis of aorta or pulmonary artery occurred.

Conclusions

In contemporary practice, percutaneous device closure is an effective and safe treatment option for adolescent and adult PDA patients.

Amplatzer®Duct Occluder device: a new technology for the closure of the moderate-to-large-sized patent ductus arteriosus

The Amplatzer Duct Occluder is a novel device designed to allow for the transcatheter closure of virtually all sized patent ductus arteriosuses. Prior technologies have been cumbersome and challenging to deploy with somewhat less than ideal closure rates associated with their use. This article summarizes the present knowledge about the Amplatzer Duct Occluder device and its various indications. With the introduction of this device as well as the use of embolization coils, all but the neonatal patent ductus arteriosuses can now be safely, consistently and successfully closed in the cardiac catheterization laboratory.

Transcatheter closure of patent ductus arteriosus using ado device: retrospective study of 149 patients

Background:

Patent ductus arteriosus (PDA) is a common form of congenital heart disease and forms about 5-10% of congenital heart diseases. Surgical closure is safe and effective; however, certain patients may experience some morbidity. Recently, transcatheter closure of PDA using the Amplatzer duct occluder has been shown to be safe and efficacious.

Objectives:

To evaluate whether transcatheter closure with this device offers an alternative to surgical closure of PDA.

Patients and Methods:

Between July 2006 to July 2008, 149 patients (98 females and 51 males) with PDA underwent cardiac catheterization in an attempt to close their PDA by transcatheter approach using Amplatzer duct occluder device.

Results:

The patient's age ranged from 4 months to 45 years (median 5 years). Successful PDA closure was achieved in 136 patients (91.2%) with 100% complete closure rate within 24 hours after the procedure. Thirteen patients (8.7%) had unsuccessful attempts, 11 (7.3%) of them had failure of deployment of the device, while embolization of the device occurred in two of the patients (1.3%).

Conclusions:

Amplatzer duct occluder device is safe and effective for closure of different types and sizes of PDA with low rate of complication.