title: Immediate and early results of closure of moderate to large patent arterial ducts using the new Amplatzer device.
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.
  
  
  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.
authors.affiliation: Division of Pediatric Cardiology, Escorts Heart Institute and Research Centre, New Delhi, India.
authors.forename: A
authors.initials: A
authors.lastname: Marwah
authors.forename: S
authors.initials: S
authors.lastname: Radhakrishnan
authors.forename: S
authors.initials: S
authors.lastname: Shrivastava
mesh_terms: 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
chemical_list: D000497:Alloys