Transcatheter PDA Closure Using the Gianturco-Grifka Vascular Occlusion Device.
Transcatheter interventional procedures for the treatment of congenital heart defects have become increasingly important. The patent ductus arteriosus (PDA) is a common congenital defect that is amenable to transcatheter occlusion. Several transcatheter occlusion devices are available. However, due to different PDA shapes and sizes, each device cannot be used to occlude every PDA. Thus, there is a need for new safe and effective transcatheter occlusion devices. We developed a new transcatheter device, the Gianturco-Grifka Vascular Occlusion Device (GGVOD), which consists of a nylon sack attached to an end-hole catheter. A wire is advanced through the catheter into the sack. The wire coils, filling the sack, occluding the vessel, and providing transmural pressure to maintain the sack position. Prior to release, the device may be repositioned, removed, or exchanged for a different sized device. The device is available in four sizes. We evaluated this device in a canine model, occluding subclavian and carotid arteries, and surgically created aortopulmonary shunts. All vessels were occluded completely without complication. In children, we have used the device to occlude PDA and other vascular anomalies. In every patient, the PDA (or other vessel) was occluded completely and without complication. When compared with other occlusion devices, this device has several advantages: the ability to reposition the device or remove it prior to release, the ability to conform to many vascular shapes, and four different sizes. The GGVOD has become another important tool in the transcatheter armamentarium.
Grifka
Ronald G.
RG
Cardiac Catheterization Laboratories, Texas Children's Hospital, 6621 Fannin, Houston, TX 77030, USA. rgrifka@bcm.tmc.edu