Closure of large patent ductus arteriosus using the Amplatzer Septal Occluder.

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.

journal_name

Cardiol Young

journal_title

Cardiology in the young

authors

García-Montes JA,Camacho-Castro A,Sandoval-Jones JP,Buendía-Hernández A,Calderón-Colmenero J,Patiño-Bahena E,Zabal C

doi

10.1017/S1047951114000183

subject

Has Abstract

pub_date

2015-03-01 00:00:00

pages

491-5

issue

3

eissn

1047-9511

issn

1467-1107

pii

S1047951114000183

journal_volume

25

pub_type

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