Transcatheter closure of moderate to large patent ductus arteriosus with the Amplatzer duct occluder.
OBJECTIVE
To investigate the acute and follow-up results of transcatheter closure of moderate to large patent ductus arteriosus (PDA) with the Amplatzer duct occluder.


METHODS
Between April 2000 and June 2005, 237 patients underwent attempted transcatheter closure of PDA, of whom Amplatzer duct occluder was used in 68 patients with moderate-to-large-sized PDA (45 females, with ages ranging from 56 days to 75 years, median 3.3 years). Moderate to large PDA is defined as ductus diameter > or =2.5 mm (> or =3 mm in early phase of this study) in infants and young children, or > or =4 mm in adolescents and adults. The size of device selected was generally at least 1-2 mm larger than ductus diameter.


RESULTS
The ductus diameter ranged from 2.5 to 8.5 mm (4.1 +/- 1.3 mm). Amplatzer duct occluder was successfully deployed in 66 out of 68 patients. The size of device deployed ranged from 4 to 12 mm (6.3 +/- 1.6 mm). The causes of failure in the 2 patients included calcification of ductus resulting, in failure in advancing a sheath to descending aorta in 1 and kinking of a Cook sheath in the other. Distal embolization of the device occurred several hours later in one. After the device was retrieved percutaneously, the patient was sent to surgery. No other significant complications occurred. In the 3-month follow-up, complete occlusion was achieved in all patients. No patient had left pulmonary artery stenosis.


CONCLUSIONS
Transcatheter closure of moderate-to-large-sized ductus with Amplatzer ductus occluder is effective and safe.
Wang
Jou-Kou
JK
Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan. jkw@ha.mc.ntu.edu.tw
Wu
Mei-Hwan
MH
Hwang
Juey-Jen
JJ
Chiang
Fu-Tein
FT
Lin
Ming-Tai
MT
Lue
Hung-Chi
HC
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D021721:Balloon Occlusion / Q000295:instrumentation*; D006328:Cardiac Catheterization; D002648:Child; D002675:Child, Preschool; D020878:Device Removal / Q000295:instrumentation; D004374:Ductus Arteriosus, Patent / Q000150:complications / Q000628:therapy*; D004868:Equipment Failure; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006976:Hypertension, Pulmonary / Q000209:etiology; D007223:Infant; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery / Q000601:surgery; D012720:Severity of Illness Index; D016896:Treatment Outcome