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


METHODS
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 8 months to 26 years and median weight of 14 kg with a range from 4.5 kg to 48 kg. The mean ductal diameter was 4.1 mm (S.D 1.51 mm). 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 3 months, 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.


CONCLUSIONS
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.
Marwah
A
A
Division of Pediatric Cardiology, Escorts Heart Institute and Research Centre, New Delhi, India.
Radhakrishnan
S
S
Shrivastava
S
S
D000293:Adolescent; D000328:Adult; D000497:Alloys; D006328:Cardiac Catheterization / Q000295:instrumentation* / Q000379:methods; D002648:Child; D002675:Child, Preschool; D004374:Ductus Arteriosus, Patent / Q000000981:diagnostic imaging / Q000628:therapy*; D015150:Echocardiography, Doppler; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D019919:Prosthesis Implantation / Q000295:instrumentation*; D012720:Severity of Illness Index; D016896:Treatment Outcome
D000497:Alloys