Experience with percutaneous closure of ductus arteriosus using the Amplatzer duct occluder in 243 consecutive patients and long-term results-A single centre study.

Abstract

Background:Percutaneous closure of patent ductus arteriosus (PDA) with Amplatzer duct occluder (ADO) has become increasingly popular in many cardiovascular centres. This study analysed the long-term results of percutaneous closure of PDA with ADO in a single centre.Materials and Methods:Between May 2004 and January 2013, 243 patients with median age of 2.5 years (range = 30 months to 38 years) and median weight of 10 Kg (range 4.5–80.5 Kg) underwent percutaneous closure of PDA using the ADO. The devices were implanted under fluoroscopic guidance. Patients were followed-up for any complications.Results:The mean diameter of narrow part of PDA was 6.4 ± 2.2 mm. The mean diameter of devices was 7.8 ± 2.3 mm. The devices were successfully implanted in 239 (98.3%) cases. At immediate, 1 day, 1, 6, 12 months and late follow-up, the complete occlusion rate was 33% (79 case), 97.1% (236 case), 97.5% (237 case), 98.3% (238 case), 98.3% (238 case) and 98.3% (238 case), respectively. Residual shunt remained in one case at late follow-up. The device embolisation occurred in five patients. The devices were successful retrieved in three patient and second larger devices were inserted. Two other devices were surgically retrieved and PDAs were ligated. Moderate left pulmonary artery stenosis (LPA) in one child and mild LPA stenosis in one infant were detected. Mild aortic obstruction occurred in one infant.Conclusions:Long-term follow-up of patients indicate that percutaneous closure of PDA using ADO is a safe and effective procedure. However, some complications, including device embolisation, left pulmonary stenosis and aortic obstruction may be observed in some cases.