Related Experiment Video
Updated: Apr 12, 2026
Closure of a Patent Foramen Ovale PFO: An Intervention Sequence
Published on: December 23, 2022
When Can We Release the Amplatzer Ductal Occluder (ADO) Safely?
Mehdi Ghaderian1, Mahmood Merajie2, Hodjjat Mortezaeian2
1Emam Hosein Medical, Educational and Research Center, Esfahan University of Medical Sciences, Esfahan, Iran ; Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
Insights
A new technique using the angle between the Amplatzer Ductal Occluder (ADO) and its cable helps safely release the device during patent ductus arteriosus (PDA) closure, especially without arterial lines.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Interventional Cardiology
Background:
- The ductus arteriosus connects the pulmonary trunk to the descending aorta.
- Isolated patent ductus arteriosus (PDA) occurs in about 1 in 2000 full-term infants.
- The Amplatzer Ductal Occluder (ADO) is indicated for PDAs larger than 2 mm.
Purpose of the Study:
- To determine the optimal release time for the ADO during PDA closure.
- To evaluate a new method for confirming ADO position without post-procedure aortography.
Main Methods:
- A retrospective study of 237 patients undergoing PDA transcatheter closure with ADO (September 2009 - September 2012).
- Data collected included patient demographics, PDA size, hemodynamic parameters, and procedural times.
- Major complications like mortality and vascular issues were monitored.
Main Results:
- The study included 237 patients (130 female, 107 male) with a mean age of 34.3 months and weight of 14.2 kg.
- Mean PDA size was 3.7 mm (range 2.1-6.2 mm).
- No significant complications were reported, with mean fluoroscopy time of 11.4 min and angiographic time of 42.0 min.
Conclusions:
- A novel sign, the angle between the ADO and its cable, aids in safe device deployment.
- This technique is particularly useful for PDA closure procedures when an arterial line is unavailable for post-procedure aortography.
Background:
The ductus arteriosus connects the main pulmonary trunk to the descending aorta. The incidence of isolated patent ductus arteriosus (PDA) in full-term infants is about 1 in 2000. The Amplatzer Ductal Occluder (ADO) is recommended for PDAs with sizes larger than 2 mm. In this procedure, we must confirm the ADO position in PDA by aortogram from the arterial line. The purpose of this study was to determine the optimal release time of the ADO in the PDA closure procedure, especially in the absence of an arterial line for post-PDA aortography.
Methods:
This study recruited all patients scheduled to undergo PDA transcatheter closure with the ADO between September 2009 and September 2012 in our center. Age, weight, PDA diameter, systolic and diastolic pulmonic pressures, fluoroscopy time, and total angiographic time were studied. Major complications such as mortality and vascular complications were considered.
Results:
We studied 237 patients in our investigation. We had 130 female and 107 male patients at a mean age of 34.3 ± 40.6 months and mean weight of 14.2 ±7.8 kg. PDA sizes ranged from 2.1 to 6.2 mm and its mean was 3.7 ± 1.8 mm. Mean of fluoroscopy time was 11.4 ± 9.7 min and mean of total angiographic time was 42.0 ± 12.3 min. There were no significant complications.
Conclusion:
We herein describe a new sign, which proved extremely helpful during our PDA closure procedures with the ADO. By considering the angle between the ADO and the cable during the procedure, the operator can release the ADO safely.
