[Percutaneous closure of patent ductus arteriosus with the Amplatzer duct occluder. Results of 29 patients].
The authors report their experience of percutaneous closure of large patent ductus arteriosus with the Amplatzer duct occluder. The age of the patients ranged from 3 months to 72 years (average 24 months) with body weights of 3.9 to 74 Kg (average 16 Kg). The smallest angiographic diameter of the ductus was 4.0 +/- 1.3 mm at angiography (range 1.8 to 6 mm). The occluder was inserted under local anaesthetic with control aortography in all but one case who required general anaesthesia. In two small babies, the implantation was performed after venous puncture alone with transthoracic echocardiographic monitoring. The implantation was successful in all but one case in which there was a distensible duct. Early angiographic control showed suppression of the shunt in 61% of patients. Secondary haemolysis was observed in one case and was corrected by a second catheterisation 4 days later, with occlusion of the duct with a balloon catheter. The patients were followed up clinically, radiologically and echocardiographically. Doppler echocardiography showed absence of a residual shunt in 24 patients (86%) one month after the procedure, in 25 patients (89%) 3 months after the procedure and in 26 patients (93%) one year after the procedure. Two patients were left with mild or moderate shunts 12 and 16 months after the attempted occlusion. No cases of aortic or pulmonary obstruction were observed. The authors conclude that the Amplatzer duct occluder is a reliable device for closing large patent ductus arteriosus. It may be proposed in young symptomatic children over 4 Kg in body weight. A high rate of occlusion is obtained with a minimal risk of complications.
Godart
F
F
Service des maladies cardiovasculaires infantiles et congénitales, CHRU de Lille, bd du Professeur-Leclercq, 59039 Lille.
Rey
C
C
Francart
C
C
Vaksmann
G
G
Brevière
G M
GM
D000293:Adolescent; D000328:Adult; D000368:Aged; D013504:Cardiovascular Surgical Procedures / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D004374:Ductus Arteriosus, Patent / Q000601:surgery*; D004452:Echocardiography; D004867:Equipment Design; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D019919:Prosthesis Implantation