title: Single-center experience in percutaneous closure of arterial duct with Amplatzer duct Occluder II additional sizes.
abstract: OBJECTIVE
  This study aimed to report a large, single-center experience of percutaneous arterial duct (AD) closure using Amplatzer Duct Occluder II Additional Sizes device (ADO II-AS)(St. Jude Medical Corp, St. Paul, MN, USA).
  
  
  BACKGROUND
  Transcatheter closure of AD remains challenging in low body weight patients and those who have a persisting shunt following a previous attempt at interventional closure. Recent technical advances in device design may address these issues.
  
  
  METHODS
  From May 2011 to April 2016, 109 patients underwent attempted percutaneous closure of AD with ADO II-AS at our Institution. Mean age and weight were 4.8 ± 8.1 years (range 0-48) and 21.4 ± 20.6 kg (range 3-93), respectively. Fifteen patients (13.8%) were ≤6 kg (age 3.5 ± 2.0 months; weight 4.7 ± 1.1 kg). Arterial duct morphology was type A in 62 (57%), type B in 1 (1%), type C in 32 (29%), type D in 7 (6%) and type E in 6 patients (6%), respectively. Arterial approach was used to negotiate and deploy the occluding device in 103 patients (94.5%).
  
  
  RESULTS
  AD diameter was 2.2 ± 0.6 (range 1.5-4.5) resulting in QP/QS of 1.9 ± 0.7 (range 1-3.3). Mean pulmonary artery pressure and PA/aortic pressure ratio were 19.3 ± 5.0 mm Hg (range 12-38) and 0.34 ± 0.14 (range 0.14-0.95), respectively. Successful device deployment was achieved in 107 patients (98.2%). Neither procedural morbidity nor mortality was recorded. Immediate, 24h and mid-term (30 ± 17 months) complete occlusion was recorded in 71%, 98.1%, and 100% of patients, respectively.
  
  
  CONCLUSIONS
  In our experience, trans-catheter closure of AD of different sizes and morphologies using ADO II-AS is highly feasible, safe and effective also in challenging anatomic/clinical settings. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Department of Paediatric Cardiology, A.O.R.N. "Ospedali dei Colli", 2nd University of Naples, Naples, Italy.
authors.forename: Heba Talat
authors.initials: HT
authors.lastname: Mahmoud
authors.affiliation: Department of Paediatric Cardiology, A.O.R.N. "Ospedali dei Colli", 2nd University of Naples, Naples, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Santoro
authors.affiliation: Department of Paediatric Cardiology, A.O.R.N. "Ospedali dei Colli", 2nd University of Naples, Naples, Italy.
authors.forename: Gianpiero
authors.initials: G
authors.lastname: Gaio
authors.affiliation: Department of Paediatric Cardiology, A.O.R.N. "Ospedali dei Colli", 2nd University of Naples, Naples, Italy.
authors.forename: Fabio Angelo
authors.initials: FA
authors.lastname: D'Aiello
authors.affiliation: Department of Paediatric Cardiology, A.O.R.N. "Ospedali dei Colli", 2nd University of Naples, Naples, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Capogrosso
authors.affiliation: Department of Paediatric Cardiology, A.O.R.N. "Ospedali dei Colli", 2nd University of Naples, Naples, Italy.
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Palladino
authors.affiliation: Department of Paediatric Cardiology, A.O.R.N. "Ospedali dei Colli", 2nd University of Naples, Naples, Italy.
authors.forename: Maria Giovanna
authors.initials: MG
authors.lastname: Russo
mesh_terms: D000293:Adolescent; D000328:Adult; D001027:Aortography; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000295:instrumentation*; D002648:Child; D002675:Child, Preschool; D004374:Ductus Arteriosus, Patent / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007558:Italy; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D055989:Septal Occluder Device; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: ASD/PDA/PFO; closure; congenital heart disease; pediatric intervention; pediatrics