title: Closure of tubular patent ductus arteriosus with the Amplatzer Vascular Plug IV: feasibility and safety.
abstract: BACKGROUND
  Closure of tubular patent ductus arteriosus remains a challenging procedure. Anecdotal use of Amplatzer Vascular Plug IV for tubular ductus closure has been reported but feasibility and safety in a consecutive patients' series remain unknown.
  
  
  METHODS
  We performed a monocenter prospective study at the Marie Lannelongue Hospital in Paris, France. From 2009 to 2014, a total of 47 patients (39 infants, 3 children, and 5 adults) underwent ductus closure with the Plug IV.
  
  
  RESULTS
  Ductus morphology was a type E in 34 (72.3%) patients and a type C in 13 (27.7%) patients. Ductus closure occurred in 39 (83.0%) infants at a median age of seven months (range: 3-23 months) and a median weight of 6.9 kg (range: 4.1-17.0 kg). A past history of prematurity and very low birth weight was found in 33 (70.2%) of them. Twelve (25.5%) patients had pulmonary hypertension. Mean Plug IV diameter was 1.9 ± 0.1 mm larger than the mean maximal ductus diameter. Early complete closure of the ductus was obtained in all patients. Early migration of an undersized Plug IV occurred in one (2.1%) patient and was suitable for percutaneous device retrieval. After a mean follow-up of 3.4 ± 1.4 years, all patients are alive and asymptomatic, no late complication occurred.
  
  
  CONCLUSIONS
  Transcatheter closure of tubular ductus with the Amplatzer Vascular Plug IV can be safe and effective, with a 100% early occlusion rate. This device, suitable for a 4F sheath, is a new alternative for tubular ductus closure in low-body-weight infants.
authors.affiliation: Department of Pediatric and Congenital Cardiac Surgery, Marie Lannelongue Hospital, French Reference Center for Complex Congenital Heart Diseases, Paris, France Department of Interventional Cardiovascular Radiology, Marie Lannelongue Hospital, Paris, France Paris Sud University, Paris Sud School of Medicine, Le Kremlin Bicêtre, Paris, France l'Institut du Thorax, INSERM 1087, CNRS 6291, Nantes University, Nantes, France a.baruteau@ccml.fr.
authors.forename: Alban-Elouen
authors.initials: AE
authors.lastname: Baruteau
authors.affiliation: Department of Pediatric and Congenital Cardiac Surgery, Marie Lannelongue Hospital, French Reference Center for Complex Congenital Heart Diseases, Paris, France Marie-Lannelongue Hospital, INSERM 999, Paris, France.
authors.forename: Virginie
authors.initials: V
authors.lastname: Lambert
authors.affiliation: Department of Interventional Cardiovascular Radiology, Marie Lannelongue Hospital, Paris, France.
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Riou
authors.affiliation: Department of Interventional Cardiovascular Radiology, Marie Lannelongue Hospital, Paris, France.
authors.forename: Claude-Yves
authors.initials: CY
authors.lastname: Angel
authors.affiliation: Department of Pediatric and Congenital Cardiac Surgery, Marie Lannelongue Hospital, French Reference Center for Complex Congenital Heart Diseases, Paris, France.
authors.forename: Emre
authors.initials: E
authors.lastname: Belli
authors.affiliation: Department of Pediatric and Congenital Cardiac Surgery, Marie Lannelongue Hospital, French Reference Center for Complex Congenital Heart Diseases, Paris, France.
authors.forename: Jérôme
authors.initials: J
authors.lastname: Petit
mesh_terms: D000328:Adult; D006328:Cardiac Catheterization; D002648:Child; D004374:Ductus Arteriosus, Patent / Q000628:therapy*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D061214:Patient Safety; D011446:Prospective Studies; D019736:Prostheses and Implants; D016896:Treatment Outcome
keywords: Amplatzer Vascular Plug IV; adult congenital heart disease; cardiac catheterization/intervention; congenital heart disease (CHD); patent ductus arteriosus (patent arterial duct); pediatric; transcatheter closure