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Closure of a Patent Foramen Ovale (PFO): An Intervention Sequence
Published on: December 23, 2022
Transcatheter closure of moderate-to-large patent ductus arteriosus in infants using Amplatzer duct occluder
Jou-Kou Wang1, Mei-Hwan Wu, Ming-Tai Lin
1Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan. jkww@ntuh.gov.tw
Insights
Transcatheter closure of patent ductus arteriosus (PDA) in infants using the Amplatzer duct occluder (ADO) is safe and effective. This minimally invasive procedure shows high success rates with minimal complications for infant PDA treatment.
Area of Science:
- Pediatric Cardiology
- Interventional Cardiology
- Medical Devices
Background:
- Transcatheter closure of patent ductus arteriosus (PDA) in infants presents significant challenges.
- Existing methods may have limitations in this vulnerable population.
Purpose of the Study:
- To evaluate the safety and efficacy of the Amplatzer duct occluder (ADO) for transcatheter closure of PDA in infants.
- To assess procedural success rates and short-term outcomes.
Main Methods:
- A cohort of 46 infants underwent PDA closure with the Amplatzer duct occluder (ADO).
- The ADO was indicated for ductus diameters >= 2.5 or 3 mm, with device size 1-3 mm larger than the ductal diameter.
- Echocardiographic follow-up was performed at 1 and 3 months post-procedure.
Main Results:
- Successful deployment of the ADO was achieved in 45 out of 46 patients (97.8% success rate).
- No severe complications were reported during the procedure.
- A small residual shunt was observed in 4 patients at 1 month, resolving by 3 months.
- One patient experienced moderate left ventricular outflow tract obstruction 2.3 years post-procedure.
Conclusions:
- Transcatheter closure of PDA in infants using the Amplatzer duct occluder (ADO) is a safe and effective therapeutic option.
- The ADO demonstrates a high success rate and favorable short-term outcomes for infant PDA closure.
Background:
There are difficulties in transcatheter closure of patent ductus arteriosus (PDA) in infants.
Methods And Results:
The 46 infants (mean age 6.2+/-2.7 months; mean body weight 6.3+/-1.6 kg) who underwent PDA closure using the Amplatzer duct occluder (ADO). The indication for using an ADO was a ductus diameter > or =2.5 or 3 mm. Device diameter selected was 1-3 mm larger than ductal diameter. The mean systolic pulmonary artery pressure was 40.9+/-18.2 mmHg. The mean Qp/Qs ratio was 3.1+/-1.2. The mean ductus diameter was 3.3+/-0.8 mm. ADO was successfully deployed in 45 patients. Failure occurred in 1 case. The mean diameter of device used was 5.4+/-1.1 mm. No severe complications occurred. At the 1-month echocardiographic follow-up, a small residual shunt was present in 4 of 45 patients and had disappeared in all 4 patients at the 3-month follow-up. One patient developed a moderate degree of left ventricular outflow tract obstruction 2.3 years after the procedure.
Conclusions:
Transcatheter closure of PDA in infants using the ADO is a safe and effective method.
