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The efficacy and safety of the Amplatzer ductal occluder in young children and infants

Published online by Cambridge University Press:  03 May 2005

Jameel Al-Ata ,
Amin M. Arfi ,
Arif Hussain ,
Amjad A. Kouatli  and
M. Omar Jalal
Jameel Al-Ata
Affiliation:
Section of Pediatric Cardiology, Department of Cardiovascular Diseases, King Faisal Specialist Hospital & Research Center, Jeddah, Kingdom of Saudi Arabia
Amin M. Arfi
Affiliation:
Section of Pediatric Cardiology, Department of Cardiovascular Diseases, King Faisal Specialist Hospital & Research Center, Jeddah, Kingdom of Saudi Arabia
Arif Hussain
Affiliation:
Section of Pediatric Cardiology, Department of Cardiovascular Diseases, King Faisal Specialist Hospital & Research Center, Jeddah, Kingdom of Saudi Arabia
Amjad A. Kouatli
Affiliation:
Section of Pediatric Cardiology, Department of Cardiovascular Diseases, King Faisal Specialist Hospital & Research Center, Jeddah, Kingdom of Saudi Arabia
M. Omar Jalal
Affiliation:
Section of Pediatric Cardiology, Department of Cardiovascular Diseases, King Faisal Specialist Hospital & Research Center, Jeddah, Kingdom of Saudi Arabia
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Abstract

Background: We have used the Amplatzer ductal occluder for transcatheter closure of large persistently patent arterial ducts, and used our experience to assess the safety and efficacy of the device in young children and infants. Methods and patients: We used the Amplatzer ductal occluder prospectively in 43 patients with large patent arterial ducts, reviewing our experience to identify any problems or complications. Results: The procedure proved successful in 42 of the patients. We achieved complete occlusion of the duct in 33 (78.5 per cent) of the patients on the day of insertion. In 6 additional patients, complete occlusion occurred 1 week to 6 months after the procedure. Trivial leaks persisted in 2 patients, while one had a significant residual leak. Problems were encountered in 7 patients. The procedure failed in one, a device was wasted in 2, pulled through in 3, while we experienced kinking of the long Mullins sheath, being unable to retrieve the device, in one patient. Minor complications occurred in 6 patients, finding flow at a peak velocity of 2.2 metres per second in the descending aorta in 2 patients, and at 2.5 metres per second in 2 further patients, and flow at 2.5 metres per second in the pulmonary arteries of two patients. One patient experienced a major complication due to excessive bleeding. Out of the 14 patients suffering adverse events, 13 weighed less than 10 kilograms. This rate of problems and complication in these patients weighing less than 10 kilograms was significantly higher than in the patients weighing more than 10 kilograms. Conclusion: Transcatheter occlusion of moderate to large patent arterial ducts with the Amplatzer ductal occluder device is safe and effective, with a high rate of complete occlusion. Problems and minor complications may be encountered in children weighing less than 10 kilograms. If the device is to be deployed completely in the ductal ampulla, and to avoid descending aortic obstruction, the size of the retention flanges of the occluder should not exceed the largest diameter of the patent arterial duct.

Keywords

Patent arterial ducttranscatheter occlusioninterventional catheterisation
Type
Original Article
Information
Cardiology in the Young , Volume 15 , Issue 3 , June 2005 , pp. 279 - 285
Copyright
© 2005 Cambridge University Press

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References

Galal O, Bulbul Z, Kakadekar A, et al. Comparison between the safety profile and clinical results of cook detachable and Gianturco coils for transcatheter closure of the patent ductus arteriosus in 272 patients. J Interven Cardiol 2001; 14: 169–178.Google Scholar
Hijazi ZM, Geggel RL. Results of anterograde transcatheter closure of patent ductus arteriosus using single or multiple Gianturco coils. Am J Cardiol 1994; 74: 925–929.Google Scholar
Hijazi ZM, Geggel RL. Transcatheter closure of large patent ductus arteriosus with multiple Gianturco coils: immediate and mid-term results. Heart 1996; 76: 536–540.Google Scholar
Galal O, de Moor M, Al Fadley F, et al. Problems encountered during introduction of Gianturco coils for transcatheter occlusion of patent arterial duct. Eur Heart J 1997; 18: 625–630.Google Scholar
Saliba Z, Aggoun Y, Hausse AO, et al. Percutaneous closure of patent ductus arteriosus with Amplatzer duct occluder. Arch Mal Coeur Vaiss 2000; 93: 533–538.Google Scholar
Masura J, Walsh KP, Thanopoulous B, et al. Catheter closure of moderate to large sized patent ductus arteriosus using the new Amplatzer duct occluder: immediate and short short-term results. J Am Coll Cardiol 1998; 31: 878–882.Google Scholar
Bilkis AA, Alwi M, Hasri S, et al. The Amplatzer duct occluder: experience in 209 patients. J Am Coll Cardiol 2001; 37: 258–261.Google Scholar
Thanopoulos BD, Hakim FA, Hiari A, Tsaousis GS, Paphitis C, Hijazi ZM. Patent ductus arteriosus equipment and technique. Amplatzer duct occluder: intermediate-term follow-up and technical considerations. J Interv Cardiol 2001; 14: 247–254.Google Scholar
Krichenko A, Benson LN, Burrows P, Moes CA, Mclaughlin P, Freedom RM. Angiographic classification of persistently patent ductus arteriosus and implication of percutaneous catheter occlusion. Am J Cardiol 1989; 63: 877–880.Google Scholar
Faella HJ, Hijazi ZM. Closure of the patent ductus arteriosus with the Amplatzer PDA device: immediate results of international clinical trial. Catheter Cardiovsc Interv 2000; 51: 50–54.Google Scholar
Duke C, Chan KC. Aortic obstruction caused by device occlusion of patent arterial duct. Heart 1999; 82: 109–111.Google Scholar
Ebeid MR, Masura J, Hijazi ZM. Early experience with the Amplatzer duct occluder for closure of the persistently patent ductus arteriosus. J Interv Cardiol 2001; 14: 33–36.Google Scholar
Thanopoulos BD, Hakim FA, Hiari A, et al. Further experience with transcatheter closure of the patent ductus arteriosus using the Amplatzer duct occluder. J Am Coll Cardiol 2000; 35: 1016–1021.Google Scholar
Marwah A, Radhakrishnan S, Shrivastava S. Immediate and early results of closure of moderate to large patent ducts using the new Amplatzer device. Cardiol Young 2000; 10: 208–211.Google Scholar
Zanchetta M, Dimopoulos K, Rigatelli G, et al. Patent ductus arteriosus closure using the new Amplatzer duct occluder: preliminary results and review of literature. Minerva Cardioangiol 2001; 49: 369–376.Google Scholar
Godart F, Rey C, Francart C, Vaksmann G, Breviere GM. Percutaneous closure of patent ductus arteriosus with the Amplatzer duct occluder. Result of 29 patients. Arch Mal Coeur Vaiss 2001; 94: 439–443.Google Scholar
Godart F, Rodes J, Rey C. Severe hemolysis after transcatheter closure of a patent arterial duct with the new Amplatzer duct occluder. Cardiol Young 2000; 10: 265–267.Google Scholar
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 defect occluder. Heart 2002; 87: 260–263.Google Scholar