title: Contraction of the Amplatzer Vascular Plug I and II in pulmonary artery and systemic venous collateral vessels is safe and of no hemodynamic or vascular consequence in short- and mid-term follow-up.
abstract: BACKGROUND
  The Amplatzer Vascular Plug (AVP) I and AVP II have been used successfully to occlude moderate-large venous collateral vessels (VC) and pulmonary arteriovenous malformations (PAVM) in children and adults with congenital heart disease.
  
  
  OBJECTIVE
  To report our experience in 4 patients who underwent device occlusion of systemic venous collaterals (3 patients) and device closure of pulmonary arteriovenous malformation (1 patient) that developed contraction of the AVP.
  
  
  METHODS
  The records of all patients who underwent device occlusion utilizing both AVP I and AVP II between November 2006 and January 2011 were retrospectively reviewed. All available follow-up chest x-rays were reviewed and compared with angiograms obtained post device occlusion. A device 30%-50% larger than the targeted vessel was utilized to occlude the vessel.
  
  
  RESULTS
  Four patients were identified with a mean age of 21 years (range, 7 years and 2 months-52 years) and mean weight of 60.6 kg (range, 15.3-131.5 kg). Two patients received AVP I and 2 patients received AVP II. One patient who received the 12 mm AVP I showed moderate contraction. The 3 other patients who received AVP I (6 mm) and AVP II (10 mm, 12 mm) all demonstrated device contraction to the original shape of the device. Mean follow-up time of 24 months (range, 12-40 months) has shown no evidence of hemodynamic or vascular compromise.
  
  
  CONCLUSIONS
  Short to mid-term follow-up indicate that contraction of AVP I and AVP II is safe with no evidence of hemodynamic or vascular compromise. Continued long-term follow-up is warranted.
authors.affiliation: Tulane University Section of Pediatric Cardiology, 1430 Tulane Avenue, SL-22, New Orleans, LA 70112, USA. mrecto@tulane.edu
authors.forename: Michael R
authors.initials: MR
authors.lastname: Recto
authors.forename: Matthew
authors.initials: M
authors.lastname: Stohs
authors.forename: Thomas
authors.initials: T
authors.lastname: Yeh
mesh_terms: D000293:Adolescent; D001165:Arteriovenous Malformations / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D002648:Child; D003097:Collateral Circulation / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000502:physiology*; D011667:Pulmonary Veins / Q000000981:diagnostic imaging / Q000502:physiology*; D013902:Radiography, Thoracic; D012189:Retrospective Studies; D055989:Septal Occluder Device / Q000009:adverse effects / Q000145:classification*; D013997:Time Factors; D016896:Treatment Outcome