Patent ductus arteriosus closure using the new Amplatzer Duct Occluder. Preliminary results and review of the literature.
BACKGROUND
Patent ductus arteriosus (PDA) is the second most common congenital heart disease. A large number of surgical and transcatheter techniques for the interruption or closure of PDA has been reported. The aim of this study was to assess the immediate and short-term results of transcatheter closure of PDA using the new, self-expandable, self-centering, and repositionable Amplatzer Duct Occluder device.


METHODS
We attempted occlusion of PDA with the Amplatzer Duct Occluder in seven consecutive patients, one child and six adults, four females and three males, between September 1999 and January 30th 2000. All PDAs but one were approached from the femoral venous site; the Amplatzer Duct Occluder size was selected in order to be 2 mm larger than the duct's diameter at its narrowest site and the mean PDA diameter was 5.4+/-2.5 mm (range 3-9). All patients underwent physical examination, chest X-ray and echocardiography within 48 hours and on first and third month after PDA occlusion.


RESULTS
Four patients had a megaphone type (type A), and three had an elongated, conical type (type E) PDA. Four patients had immediate, complete angiographic closure of the ductus 10 minutes after the procedure, one had a trace shunt and two had small shunts which all disappeared within 48 hours. The average fluoroscopy time and procedural time were 34.4+/-10.6 min (range 21-50) and 105+/-38.9 min (range 75-190) respectively. There were no complications at follow-up.


CONCLUSIONS
Transcatheter closure of PDA using the new Amplatzer Duct Occluder is an easy and effective technique. Moreover it is safe even in the presence of wide PDAs.
Zanchetta
M
M
Dipartimento di Malattie Cardiovascolari, ASL15, Cittadella, Italy. emodinacit@ulss15.pd.it
Dimopoulos
K
K
Rigatelli
G
G
Pedon
L
L
Zennaro
M
M
Pieri
D
D
Rubino
A
A
Bartorelli
A L
AL
Maiolino
P
P
Onorato
E
E
D000293:Adolescent; D000328:Adult; D000368:Aged; D006328:Cardiac Catheterization; D002309:Cardiology / Q000295:instrumentation; D004374:Ductus Arteriosus, Patent / Q000628:therapy*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged