Abstract
Introduction: Transcatheter PDAclosure has gained acceptance over surgery because of its cosmetic benefits, shorter hospital stay and absence of pain associated with a thoracotomy. The Amplatzer Ductal Occluder II (ADOII) device provides a solution for the closure of small to moderate-sizedPDAs Objective: To describe early single-centre clinical experience withADOII. Methods: Children with a haemodynamically significant patent ductus arteriosus (PDA) who underwent percutaneous trans-pulmonary closure with Amplatzer Ductal Occluder II (ADO II) were included. Data was collected from computer based patient records. Results: Trans-pulmonary PDAclosures usingADOII were undertaken in 65 children (46 females) with a mean age of 2years 3 months (range 5 months to 14 years) and a mean weight of 9.6kg (range 4.2-25kg). Complete occlusion was noted pre-discharge in 64 (98.4%) patients. One (1.6%) had residual shunting after deployment followed by embolization to the left pulmonary artery on the third day of the procedure. Of the 65 children, five (7.7%) had mild flow acceleration in the left pulmonary artery and another one (1.6%) had mild aortic flow obstruction following the procedure. At 7 and 30 days, echocardiography confirmed complete ductal occlusion without need for further intervention in all 64 (98.4%) successful cases. Conclusions: ADO II is highly effective in rapid occlusion of morphologically varied small to moderate-sized PDAs.
Highlights
Transcatheter patent ductus arteriosus (PDA) closure has gained acceptance over surgery because of its cosmetic benefits, shorter hospital stay and absence of pain associated with a thoracotomy
One (1.6%) had residual shunting after deployment followed by embolization to the left pulmonary artery on the third day of the procedure
Of the 65 children, five (7.7%) had mild flow acceleration in the left pulmonary artery and another one (1.6%) had mild aortic flow obstruction following the procedure
Summary
Transcatheter PDA closure has gained acceptance over surgery because of its cosmetic benefits, shorter hospital stay and absence of pain associated with a thoracotomy. The Amplatzer Ductal Occluder II (ADO II) device provides a solution for the closure of small to moderate-sized PDAs. The reported incidence of patent ductus arteriosus (PDA) in infants ranges from 0.138 to 0.8 per 1000 live births [1,2]. Since the initial description by Portsmann et al of nonsurgical closure of PDA the percutaneous approach has become standard clinical practice [1]. The ADOII device provides a solution for the closure of small to moderate-sized PDAs. The ADOII device is a modification of the ADOI device as produced by AGA Medical Corporation. The ADOII device is a modification of the ADOI device as produced by AGA Medical Corporation It is one of the ranges of vascular occlusion devices based on nitinol wire meshes shaped in sequential lobes
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