Patent Ductus Arteriosus (original) (raw)
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Nigerian Medical Journal, 2014
Since then, a variety of devices has been developed for percutaneous closure of PDA. At present almost all the cardiovascular centers prefer use of Amplatzer duct occluder (ADO) as the safe and effective technique. We herein report the immediate, short, mid-term and longterm results of percutaneous closure of PDA with ADO from a single centre. consecutive patients with significant PDA were considered for percutaneous closure with ADO. The 17 infant patients excluded because of weight < 4.5 Kg and severe heart failure after clinical and 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.
Follow-Up Results of Device Occlusion of Patent Ductus Arteriosus
Iranian Journal of Pediatrics, 2016
Background: Transcatheter patent ductus arteriosus (PDA) closure is an established procedure. Objectives: The aim of the study was to assess midterm follow up of the Nit-Occlud coil and the amplatzer ductal occluder (ADO) closure of PDA. Patients and Methods: In this cohort study, we collected the longitudinal data of patients who underwent percutaneous closure using coil or ADO from November 2005 to November 2013. A total of 404 patients with PDA closure by devices were included during the study period. Coil occlusion was performed in 220 patients and 184 patients underwent catheterization using ADO. Follow-up evaluations were performed with echocardiography at two weeks, two months, six months, and during the study period (in average 4.8 ± 3.8 years). Results: The patients' mean age was 24 months (range: 1-312). The catheterization was successful in 393 (97.2%) patients and unsuccessful in 11 (2.7%). Immediate complete occlusion was seen in 290 (73.7 %) patients. The occlusion rates at two weeks, two months, six months, and during the study period were 73.7%, 84%, 93.6%, 98.7%, and 99.5%, respectively. Complications occurred in 23 (5.8%) patients during or immediately after the catheterization, and device embolization with 2.7% was the most common complication. Most complications occurred in a patient with pulmonary hypertension who was less than one year old and was undergoing the first year of experience with devices. Conclusions: Our findings showed that transcatheter occlusion of the PDA is an effective and safe intervention by coil or Amplatzer with excellent early and one-year outcomes. Pulmonary hypertension, age of less than 12 months and experience of less than one year may increase the complications of device closure.
Catheterization and Cardiovascular Interventions, 2000
Background The aim of our study was to share our clinical experience on cases with patent ductus arteriosus treated with the Amplatzer Duct Occluder II. Methods Between 2008 and 2012, 26 of 31 patients with patent ductus arteriosus underwent successful transcatheter closure of patent ductus arteriosus using the Amplatzer Duct Occluder II. Mean age was 3.3 years and mean weight was 15.7 kilograms. The presence of a residual shunt, left pulmonary artery or aortic obstruction was explored by administering contrast material during the procedure. The patients were discharged 24 hours after the procedure. Results The procedure was successful in 26 of 31 patients and failed in fi ve patients. According to the Krichenko classifi cation, 26 patients had type A, one patient had type B and 4 patients had type C ductus. The mean narrowest ductus diameter was 3.2 mm and the mean ductus length was 6.7 mm. Complete angiographic occlusion occurred immediately after the procedure in 22 out of 26 patients in whom the ductus was closed successfully with the Amplatzer Duct Occluder II. Complete occlusion was achieved in the remaining patients with residual shunt one month after the procedure. The procedure was preceded by closure with an Amplatzer Duct Occluder I in two patients and an Amplatzer Vascular Plug I in one patient. Conclusion Amplatzer Duct Occluder II is highly eff ective in transcatheter closure of patent ductus arteriosus. We think that an alternative closure device and alternative techniques can be attempted in patients with type C ductus. The success rate could increase with accumulating experience.
Heart, 2004
Background: Over the past three decades, transcatheter occlusion of patent ductus arteriosus (PDA) has evolved to be the procedure of choice. Gianturco and Flipper coils are the most commonly used coils in the United States for closure of small and moderate size PDAs. For larger PDAs, interventionalists in the United States commonly use the Amplatzer Duct Occluder (ADO) and those in Europe use the ADO or the Nit-Occlud Coils (NOC). A comparison between Gianturco coils, Flipper coils, ADO, and NOC has never been made. Objective: To compare the success and complication rate associated with the four different devices used for transcatheter closure of PDA. Success was defined as complete closure of PDA with absence of a residual shunt (R.S.) at six months follow-up. Methods: Two institutions collaborated in combining their data to evaluate the results of transcatheter closure of PDA. Results: Totally, 546 patients underwent successful PDA occlusion at both institutions. Gianturco and Flipper coils were used in 120 (22%) and 119 (22%) patients respectively. A total of 152 (28%) patients received ADO and 155 (28%) patients received NOC. Immediate R.S. were noted in 226 (41.4%) patients in the entire study group with the NOC group having the highest percentage of R.S. (80/155, 51.6%, P 5 0.004). Of the 484 patients with follow-up echocardiograms at 6 months, 35 (7.2%) patients had persistent R.S. The NOC (3/143, 2.1%) and ADO (5/150, 3.3%) groups had the least R.S. at six months follow-up. Conclusion: Per our definition of success, the Nit-Occlud coils and the Amplatzer duct-occluder devices had significantly higher success rate for PDA occlusion versus the coils. V C 2009 Wiley-Liss, Inc.
Transcatheter device closure of patent ductus arteriosus
Journal of the College of Physicians and Surgeons--Pakistan : JCPSP, 2014
To determine the efficacy, safety and immediate complications encountered during percutaneous device closure of patent ductus arteriosus (PDA). Case series. Department of Paediatric Cardiology, AFIC/NIHD, Rawalpindi, from January 2005 to December 2010. Consecutive 500 patients who underwent attempted transcatheter PDA device closure were included in the study. Device type position, success of closure and complications were described as frequency percentage. In 491 cases (98.2%), PDA was successfully occluded including 4 cases (0.8%) where devices were dislodged but retrieved and redeployed in Cath laboratory. PDA occluder devices used in 448 cases (91%) while coils (single or multiple) were used in 42 cases (8.5%) and in one case (0.2%) ASD occluder device was used to occlude the PDA. There were 09 (1.8%) unsuccessful cases, 06 (1.2%) were abandoned as ducts were considered unsuitable for device closure, 02 (0.4%) devices dislodged and needed surgical retrieval and one case (0.2%) w...
Complications of Transcatheter Closure in Patent Ductus Arteriosus Patients
international cardiovascular research journal, 2017
Background: Published studies have shown excellent success rates and also low rates of life-threatening complications with trans-catheter closure of patent ductus arteriosus (PDA). However, most studies to date have been conducted in developed nations and reports from developing countries such as Iran are lacking. Objectives: To report our experience with trans-catheter closure of patent ductus arteriosus (PDA) and compare two devices and complications. Patients and Methods: From 2007 to 2011, 72 consecutive PDA cases were prospectively enrolled. For PDAs ≤ 2 mm, the coiling method was employed whereas patients with PDA > 2 mm received Amplatzer duct occlusion (ADO). Success was defined as trivial residual shunt (< 1 mm) in the echocardiography performed 30 minutes after the procedure. After the procedure, the patients were admitted to the pediatric cardiology ward and observed for 72 hours during which the occurrence of major and minor complications was monitored. Major complications included cardiac arrest, displacement and/or embolization of the device and patient needing blood transfusion due to severe hemorrhage. Sampling was based on convenience method and the patients who had significant pulmonary artery hypertension were excluded from our study. Statistical analyses were done using SPSS software version 23 (IBM corp., New York, United States). Continuous variables are presented as mean ± standard deviation. The Mann-Whitney U test was used to compare the differences between two independent groups. Categorical variables were depicted as proportions and compared across the intervention groups, using Chi-square with Fisher's exact text where appropriate. In all tests, a P value < 0.05 was deemed necessary to reject the null hypothesis. Results: With the coiling (n = 39) and Amplatzer methods (n = 33), successful closure was observed totally and recovered with no major complications. Frequent complications were benign arrhythmia (44.4%), and hemorrhage in 1 (1.4%) of the patients. Complication rate did not differ between the two techniques (P > 0.05). Conclusions: Excellent and comparable success rates for both closure techniques were observed and no major complications were observed.
Circulation, 1987
The first successful application of a transcatheter closure technique for patent ductus arteriosus (PDA) suitable for use in infants and children was performed by us in 1977. Since that time, there has been continued improvement and simplification of the equipment as well as in the implantation technique. Following a Food and Drug Administration protocol, a multicenter study was conducted to test the safety and effectiveness of this interventional method. The clinical results from three major regional test centers (Philadelphia, Houston, and New Haven) are presented. One hundred fortysix patients from a test population of 156 were treated for PDA with use of the Rashkind PDA Occluder Systems. Successful closure was accomplished in 94 (66%) of the total cases. Ten patients (7%) retained residual ductal murmurs despite correct placement of the occlusion devices; five additional patients (3%) were considered failures due to the presence of abnormal Doppler flow patterns after the procedure. Postrelease embolizations occurred in 19 (15%) instances. One patient required emergency surgical intervention after attempted retrieval of an embolized occluder. With the improvements in the manufacturing of the double-disk occluder systems as well as the perfection of the transvenous delivery technique, the incidences of closure failure and postrelease complications have decreased. Since January 1984, 78% of all transcatheter closure attempts were successful, with 10% embolization.
Journal of Interventional Cardiology, 2001
Between May I997 and June 2000, 69 patients, ages 0.1 to 34 years, underwent attempted anterograde transcatheter closure of a patent ductus arteriosus (PDA) using the Amplatzer Duct Occluder (ADO). The ADO is a cone-shaped, self-centering, and repositionable occluder made of nitinol wire mesh. A 5Fr to 7Fr sheath was used for the delivery of the device. The mean PDA diameter (at the pulmonary end) was 4.6 ? 1.9 mm (range 1 mm-8.5 mm). Sixty-seven of the 69 patients had successful device placement. The mean ADO smallest diameter was 6.9 _f 1.8 mm (range 4 mm-12 mm). Complete angiographic closure occurred in 62 (92.5%) of 67patients (95% confidence interval, 88.22%-98.77%). In five patients, there was a trivial residual shunt immediately after the procedure. At 24 hours, color Dopplerflow imaging revealed complete closure in all 67 (100%) patients. The unsuccessful attempts occurred in two patients with a small, I-mm diameter native PDA and residual PDA after surgical occlusion. Fluoroscopy time was 7.6 2 1.8 minutes (4 min-18 min). No complications were observed. At a median follow-up of 1.5 years (range 0.25 to 3.2 years), all patients had complete closure without complications. We conclude that transcatheter closure using the ADO is a highly effective and safe treatment for most patients with PDA.