Transcatheter Closure of Moderate-to-Large Patent Ductus Arteriosus in Infants Using Amplatzer Duct Occluder

Abstract

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 ≥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. (Circ J 2010; 74: 361-364)