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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: zabal@cardiologia.org.mx
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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 

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