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Immediate and early results of closure of moderate to large patent arterial ducts using the new Amplatzer™ device

Published online by Cambridge University Press:  19 August 2008

Ashutosh Marwah ,
S. Radhakrishnan  and
Savitri Shrivastava
Ashutosh Marwah
Affiliation:
Division of Pediatric Cardiology, Escorts Heart Institute and Research Centre, New Delhi, India
S. Radhakrishnan*
Affiliation:
Division of Pediatric Cardiology, Escorts Heart Institute and Research Centre, New Delhi, India
Savitri Shrivastava
Affiliation:
Division of Pediatric Cardiology, Escorts Heart Institute and Research Centre, New Delhi, India
*
Dr S. Radhakrishna, Division of Pediatric Cardiology, Escorts Heart Institute & Research Centre, Okhla Road, New Delhi–110025, India. Tel: 91–11–6825000, 91–11–6825001; Fax: 91–11–6825013; E-mail: [email protected]
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Abstract

Objective

Our aim was to assess the immediate and short term results of closure of moderate and large patent arterial ducts using the self-expanding and repositionable Amplatzer device.

Method

We attempted closure in 25 patients (10 Females and 15 males) using the Amplatzer occluder. Their median age was 48 months with a range from 8months to 26years and median weight of 14kg with a range from 4.5kg to 48kg. The mean ductal diameter was 4 (S.D 1.51mm). A 6F/7F long sheath was used to deliver the device. Follow up was performed with colour- flow mapping of the pulmonary trunk within 24 hours, at 3 months, and 6 months of closure.

Results

Of the 25 patients, the device was placed successfully in 23. Concurrent angiography showed immediate closure in 12 patients, while 8 had trivial shunting and 3 had mild shunting. Within 24 hours, Doppler examination revealed complete closure in all but three patients, who had a mild residual shunt. Two attempts were unsuccessful. Both these patients underwent successful surgical ligation. All except one patient were discharged on the next day. Of the 23 patients, 15 (65%) have been followed up for 3months, while 8 (35%) have completed 6 months of follow-up. Of the three patients initially with mild residual flow, two had completely closed at 3 months The one remaining patient is yet to be seen at the 3 month follow-up. Thus, at 3 months, all patients studies had shown complete closure.

Conclusion

Antegrade transcatheter closure using the Amplatzer duct occluder is an efficacious treatment for bigger patent arterial ducts. Long-term follow-up is necessary to show sustained benefits and confirm the absence of side effects.

Keywords

Patent arterial ductAmplatzer device
Type
Original Articles
Information
Cardiology in the Young , Volume 10 , Issue 3 , May 2000 , pp. 208 - 211
Copyright
Copyright © Cambridge University Press 2000

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