Hostname: page-component-cd9895bd7-gvvz8 Total loading time: 0 Render date: 2024-12-22T23:29:53.924Z Has data issue: false hasContentIssue false
  • English
  • Français

Closure of large patent ductus arteriosus using the Amplatzer Septal Occluder

Published online by Cambridge University Press:  21 February 2014

José A. García-Montes ,
Anahí Camacho-Castro ,
Juan P. Sandoval-Jones ,
Alfonso Buendía-Hernández ,
Juan Calderón-Colmenero ,
Emilia Patiño-Bahena  and
Carlos Zabal
José A. García-Montes
Affiliation:
Department of Interventional Cardiology, National Institute of Cardiology “Ignacio Chavez”, Mexico City, Mexico
Anahí Camacho-Castro
Affiliation:
Department of Interventional Cardiology, National Institute of Cardiology “Ignacio Chavez”, Mexico City, Mexico
Juan P. Sandoval-Jones
Affiliation:
Department of Interventional Cardiology, National Institute of Cardiology “Ignacio Chavez”, Mexico City, Mexico
Alfonso Buendía-Hernández
Affiliation:
Department of Pediatric Cardiology, National Institute of Cardiology “Ignacio Chavez”, Mexico City, Mexico
Juan Calderón-Colmenero
Affiliation:
Department of Pediatric Cardiology, National Institute of Cardiology “Ignacio Chavez”, Mexico City, Mexico
Emilia Patiño-Bahena
Affiliation:
Department of Pediatric Cardiology, National Institute of Cardiology “Ignacio Chavez”, Mexico City, Mexico
Carlos Zabal*
Affiliation:
Department of Interventional Cardiology, National Institute of Cardiology “Ignacio Chavez”, Mexico City, Mexico
*
Correspondence to: Dr C. Zabal, MD, Juan Badiano 1, Col. Seccion XVI, Tlalpan, 14080 Mexico City, Mexico. Tel: +52(55)55732911, Ext. 1336; Fax: +52(55)54851568; E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: Percutaneous closure of patent ductus arteriosus has become the treatment of choice in many centres. In patients with large ducts and pulmonary hypertension, transcatheter closure has been achieved with success using the Amplatzer Duct Occluder or even the Amplatzer Muscular Ventricular Septal Defect Occluder. Materials and methods: We present a series of 17 patients with large and hypertensive ductus arteriosus who were treated with an Amplatzer Septal Occluder. The group had 11 female patients (64.7%) and a mean age of 18.6±12.1 years. Results: The haemodynamic and anatomical data are as follows: pulmonary artery systolic pressure 71.3±31.8 mmHg, pulmonary to systemic flow ratio 3.14±1.36, ductal diameter at the pulmonary end 12.5±3.8 mm, and at the aortic end 20.2±7.7 mm; 14 cases (82.3%) had type A ducts. In 11 patients, we began the procedure using a different device – six with duct occluder and five with ventricular septal occluder – and it was changed because of device embolisation in six (35.3%). All septal occluders were delivered successfully. Residual shunt was moderate in six patients (35.3%), mild in eight (47%), trivial in two (11.8%), and no shunt in one (5.9%). Pulmonary systolic pressure decreased to 48.9±10.8 mmHg after occlusion (p=0.0015). Follow-up in 15 patients (88.2%) for 28.4±14.4 months showed complete closure in all cases but one, and continuous decrease of the pulmonary systolic pressure to 31.4±10.5 mmHg. No complications at follow-up have been reported. Conclusions: The Amplatzer Septal Occluder is a good alternative to percutaneously treat large and hypertensive ductus arteriosus.

Keywords

Congenital heart diseasepaediatric interventional cardiologydevice closurepulmonary arterial hypertension
Type
Original Articles
Information
Cardiology in the Young , Volume 25 , Issue 3 , March 2015 , pp. 491 - 495
Copyright
© Cambridge University Press 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Porstman, W, Wierny, L, Warnke, H. Closure of a persistent ductus arteriosus without thoracotomy. Ger Med Mon 1967; 12: 259–261.Google Scholar
2. Ghasemi, A, Pandya, S, Reddy, SV, et al. Trans-catheter closure of patent ductus arteriosus-what is the best device. Catheter Cardiovasc Interv 2010; 76: 687–695.Google Scholar
3. Brunetti, MA, Ringel, R, Owada, C, et al. Percutaneous closure of patent ductus arteiosus: a multiinstitutional registry comparing multiple devices. Catheter Cardiovasc Interv 2010; 76: 696–702.CrossRefGoogle Scholar
4. Thanopoulos, BD, Tsaousis, GS, Djukic, M, Al Hakim, F, Eleftherakis, NG, Simeunovic, SD. Transcatheter closure of high pulmonary artery pressure persistent ductus arteriosus with the Amplatzer Muscular Ventricular Septal Occluder. Heart 2002; 87: 260–263.CrossRefGoogle Scholar
5. García-Montes, JA, Zabal, C, Calderón-Colmenero, L, Espínola, N, Fernández de la Reguera, G, Buendía-Hernández, A. Cierre percutáneo de conducto arterioso y comunicación interventricular muscular con dispositivo Amplatzer en paciente con hipertensión pulmonar acentuada. Arch Cardiol Mex 2005; 75: 320–326.Google Scholar
6. Zabal, C, García-Montes, JA, Buendía-Hernández, A, et al. Percutaneous closure of hypertensive ductus Arteriosus. Heart 2010; 96: 625–629.CrossRefGoogle ScholarPubMed
7. Spies, C, Ujivari, F, Schräder, R. Transcatheter closure of a 22 mm patent ductus arteriosus with an Amplatzer Atrial Septal Occluder. Catheter Cardiovasc Interv 2005; 64: 352–355.Google Scholar
8. Moszura, T, Niwald, M, Dryzek, P, Moll, J, Sysa, A. Successful closure of a large PDA with an Amplatzer Septal Occluder in a child with heart failure and pulmonary hypertension – a case report. Kardiol Pol 2006; 64: 1284–1286.Google Scholar
9. Zanjani, KS. Closure of a short patent ductus arteriosus using an atrial occluder. Chin Med J (Engl) 2010; 123: 1220–1221.Google Scholar
10. Fatema, NN. Closure of large patent ductus arteriosus by Amplatzer Septal Occluder (ASO): A case report. JAFMC Bangladesh 2009; 5: 46–48.Google Scholar
11. Yang, SW, Zhous, YJ, Hu, DY, et al. Feasibility and safety of transcatheter intervention for complex patent ductus arteiosus. Angiology 2010; 61: 372–376.CrossRefGoogle Scholar
12. Krichenko, A, Benson, LN, Burrows, P, Möes, CA, McLaughlin, P, Freedom, RM. Angiographic classification of the isolated, persistently patent ductus arteriosus and implications for percutaneous catheter occlusion. Am J Cardiol 1989; 63: 877–880.Google Scholar