Patent ductus arteriosus device embolization (original) (raw)
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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.
Successful patent ductus arteriosus device closure in a patient with massive pulmonary embolism
Journal of Cardiology Cases, 2014
Patent ductus arteriosus, an essential vasculature structure during fetal life that becomes abnormal after 3 months of age, may be silent. However, the incidence of silent patent ductus arteriosus is as high as 1 in 500 patients. Existence of patent ductus arteriosus leads to left-to-right shunt. The development of pulmonary embolism in left-to-right shunt is rare. We present a case of a 33-year-old male patient who was incidentally diagnosed to have large patent ductus arteriosus along with the left-to-right shunt while being treated for pulmonary embolism. The patient was treated electively with device closure of patent ductus arteriosus. <Learning objective: Pulmonary embolism in left-to-right shunt (although there is a large patent ductus arteriosus) cannot be overlooked. Device closure of large patent ductus arteriosus is possible in patients with massive pulmonary embolism.>
Patent Ductus Arteriosus Device Closure with Venous Only Access - A Retrospective Analysis
Journal of Evolution of Medical and Dental Sciences
BACKGROUND Patent ductus arteriosus (PDA) can be closed percutaneously by a device with and without arterial access. The conventional technique involves a femoral arterial as well as femoral venous access for closure. Here we discuss our institutional data in closing the PDA without arterial access. We wanted to study retrospectively the feasibility and outcome of PDA device closure in young children via femoral vein without femoral arterial access. METHODS From November 2011 to March 2018, 228 patients were evaluated clinically and echocardiographically for PDA device closure and 201(88 %) were found suitable. These 201 patients who underwent transcatheter PDA closure via femoral venous access were included in the study. Detailed 2D echocardiography and Doppler assessment were performed before the procedure. During transcatheter closure, fluoroscopic injections were done in two views by the catheter stationed at the PDA ampulla into the descending thoracic aorta. All PDAs were clos...
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...
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.
Archives of Cardiovascular Diseases, 2009
Background. -Despite the availability of effective devices, percutaneous closure of patent ductus arteriosus (PDA) can be challenging in some situations. Aim. -To describe our initial experience of percutaneous PDA closure. Methods. -Between 2001 and 2007, 73 consecutive patients aged 3 months to 70 years underwent transcatheter PDA closure. An Amplatzer duct occluder (ADO) was chosen for ducts greater than 2 mm (n = 50) and a Detachable coil (DC) for smaller ducts (n = 23).
Indian Heart Journal, 2013
Objective: Retrospective analysis of feasibility, safety and advantages of device closure of patent ductus arteriosus (PDA) using only venous access. Background: Arterial access for transcatheter device closure of PDA has been a standard practice, but has inherent complications, especially in infants. Method: Records of patients who underwent PDA device closure from 2004 to 2012 were reviewed. Echocardiography was used for patient selection and for assessment of procedural outcome. Result: 151 out of 179 patients underwent PDA device closure with venous access alone, weighing 2.2e58 kg with half <10 kg and follow up of 6 monthse8 years. Fluoroscopic time ranged from 2.2 to 16 min. Immediate closure was achieved in 146 patients. Two patients had new-onset left pulmonary artery turbulence and one had residual flow. Conclusion: PDA device closure without arterial access can be accomplished safely and effectively in vast majority of patients including infants.
Journal of Interventional Cardiology, 2014
Device closure of patent ductus arteriosus (PDA) is treatment of choice. But device closure in presence of pulmonary artery hypertension (PAH) remains a challenge. Data on patient selection, technical considerations, and complications are limited. Aim: To know the challenges and efficacy of device closure of PDA with PAH. Materials and Results: Out of 1,325 cases of device closure of PDA, 246 (18.6%) with PAH formed the study material. To test the feasibility, chosen device is used to occlude PDA for ten minutes without oxygen inhalation. The device is released only if PAH reduced. PAH decreased in all except in 1 patient after closure with muscular ventricular septal occluder (MVSDO), pulmonary artery pressure (PAP) transiently increased (became suprasystemic), without significant reduction in aortic pressure. Device embolized in 8 patients (3.3%). Percutaneous retrieval was done in 4 (by snare in 2 and by fixing the cable to device in 2) and replaced with bigger devices. The surgical removal of the embolized MVSDO and ligation was done in 4 cases. All patients were on oral sildenafil and bosentan until PAP regressed to normal. Follow up was from 6 months to 9 years. No residual shunt in any patient on follow-up. The PAP regressed to normal in all except 5 cases (2.03%) of Down's syndrome with systemic PAP. Conclusions: Device closure of PDA with PAH is feasible, safe in all age groups. Temporary PDA occlusion with device is effective and time saving for evaluating pulmonary vascular reactivity. Device embolization in aorta is higher with severe PAH. Novel method of retrieval is effective.
The Professional Medical Journal
Background: Device closure of Patent ductus arteriosus (PDA) using AmplatzerDuct Occluder (ADO) is a well-known modality to treat PDA with limited complicationsObjectives: To assess the efficacy, safety and immediate complications of percutaneous deviceclosure of PDA using Amplatzer Duct Occluder. Study Design: Descriptive case series. Placeand Duration of Study: Paediatric Cardiology Department of Faisalabad Institute of Cardiology,Faisalabad from May, 2012 to July, 2017. Methods: All consecutive patients undergoingcardiac catheterization for device closure were included. Detailed Echocardiography was doneby dedicated pediatric cardiologist before the procedure. Successfulness of procedure andproblems were recorded. Results: Out of 74 patients two had unsuitable anatomy for deviceocclusion so were excluded while 72 patients underwent successful device closure. Completeocclusion was achieved in all cases (100%) without any residual leak. There was not a singlecase of device emboliza...