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The new Amplatzer duct occluder II: when is its use advantageous?
Zuzana Venczelova1, Peter Tittel, Jozef Masura
1Department of Functional Diagnostics, Children's Cardiac Centre, National Institute of Cardiovascular Diseases, Bratislava, Slovakia. suzanne@venczel.net
Insights
The Amplatzer duct occluder II offers safe and effective closure for arterial ducts, featuring smaller sheath sizes and a softer shape for improved outcomes in pediatric patients.
Area of Science:
- Pediatric Cardiology
- Interventional Cardiology
- Medical Devices
Background:
- Patent ductus arteriosus (PDA) is a common congenital heart defect.
- Device-based closure has become a preferred alternative to surgical ligation.
- The Amplatzer duct occluder (ADO) and Amplatzer duct occluder II (ADO II) are commonly used devices for PDA closure.
Purpose of the Study:
- To evaluate the safety and efficacy of ADO and ADO II in various arterial duct types.
- To identify specific ductal anatomies where ADO II offers advantages.
Main Methods:
- Retrospective analysis of catheterization and follow-up data.
- Inclusion of all pediatric patients undergoing device-based ductal closure between September 2005 and February 2010.
- Categorization into ADO group (n=44) and ADO II group (n=52).
Main Results:
- Successful closure was achieved in all patients in the ADO group (95.45% complete closure at 24 hours) and nearly all in the ADO II group (98.08% complete closure at 24 hours).
- No major complications were reported in either group.
- Two cases in the ADO II group required device replacement due to aortic isthmus protrusion.
Conclusions:
- Duct closure with ADO II is a safe and effective interventional procedure.
- ADO II offers benefits such as smaller sheath sizes and a softer device profile.
- Both ADO and ADO II are effective for device-based closure of arterial ducts in children.
Objectives:
To determine the safety and efficacy of the Amplatzer duct occluder and the Amplatzer duct occluder II in different types of arterial ducts, and to determine in which types of ducts the use of this new device can be advantageous.
Methods:
All children with a device-based ductal closure between September, 2005 and February, 2010 were included. We retrospectively analysed the catheterisation and follow-up data.
Results:
Between September, 2005 and February, 2010, 44 ducts were closed with the Amplatzer duct occluder - group Amplatzer duct occluder - and 52 ducts were closed with the Amplatzer duct occluder II - group Amplatzer duct occluder II. In the Amplatzer duct occluder group, the mean age was 3 years and 4 months, and the mean weight was 14.7 kilograms. Closure was successfully performed in all children. Complete closure at 24 hours was attained in 42 of 44 children (95.45%). No major complications occurred. In the Amplatzer duct occluder II group, the mean age was 6 years and 2 months, and the mean weight was 25.4 kilograms. Closure was successfully performed in all children, except in two children in whom the occluder protruded into the aortic isthmus and was replaced by the Amplatzer duct occluder. Complete closure at 24 hours was attained in 51 of 52 children (98.08%). No major complications occurred.
Conclusion:
In our experience, duct closure with the Amplatzer duct occluder II is a safe and effective method. The advantages of using it are the smaller sheath sizes and softer shape.
