Patent ductus arteriosus endovascular closure by amplatzer duct occluder.
Transcatheter occlusion of patent ductus arteriosus (PDA) using various occluding devices and coils is a widely accepted alternative to surgical closure in most pediatric cardiology centers. In spite of these advantages in transcatheter management, the occlusion of the moderate and the large PDA remains a challenge. The Amplatzer Duct Occluder (ADO) (AGA Medical, Golden Valley, MN, USA) is a new device with easy placement. It is reported to have higher rates of occlusion than other occluders currently available for transcatheter closure of PDA. 18 patients (6 male and 12 female) underwent transcatheter closure of PDA using the ADO. The mean PDA minimal diameter (pulmonary end) was 5,4+/-2,8 mm (range 4,0 mm-12 mm). We do not use ADO for small PDA closure (</=3 mm). The patients weight range was from 11 to 68 kg (mean 14,2 kg); the age range 10 month to 21 years (mean 7,3 years). The pulmonary to systemic flow ratio (Qp/Qs) ranged 2,3-4 (mean 2,6+/-1,4). All patients had no high pulmonary pressure (the highest mean pulmonary artery pressure was 35 mmHg). In all patients device was easily delivered and deployed. Complete angiographic closure at the end of the procedure was present in 16 patients (90%) of 18 patients, but there were evidence of complete PDA closure during first 12 hours. Foaming (minor diffuse leak through the Dacron fabric and no contras jet) was seen in 16 patients (98%) but was disappeared within 8-12 minute. Fluoroscopy time was 6,9+/-5,9 minutes (3,9-15 min). No complications were observed. Our experience indicates that the ADO is a highly efficient device that can be safely applied in most patients with PDA. Closure with ADO results in a 100% (in our limited study) occlusion rate at short and long term results.
Khelashvili
V
V
The Jo Ann Medical Center.
Gogorishili
I
I
Metreveli
I
I
Tsintsadze
A
A
Botsvadze
T
T
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004374:Ductus Arteriosus, Patent / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000295:instrumentation*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D016896:Treatment Outcome