Closure of very large PDA with pulmonary hypertension: Initial clinical case‐series with the new Occlutech^® PDA occluder

Abstract

With the new Occlutech PDA Occluder closure of very large PDAs and PAH is feasible and efficient. The wider pulmonary artery end of the Occlutech PDA Occluder offers enhanced stability and reduces the risk of embolization. © 2016 Wiley Periodicals, Inc.

Percutaneous closure of patent ductus arteriosus with the Nit-Occlud® patent ductus arteriosus device in 268 consecutive cases

“…The higher degree of residual shunting found immediately after device implantation is a feature which has been reported for other devices as well, especially when used to close larger ducts. [713161718] In our opinion, this initial high rate of residual shunting is not a sign of an ineffective device as it does not indicate the long-term success of PDA closure by the device. In our patient population, there were no cases of postinterventional hemolysis or endocarditis during the complete follow-up period, and we did not see further thromboembolic complications apart from one patient with an ischemic stroke with no residual sequelae.…”

“…Today, the interventionalist has a wide range of occluder types and coils, mostly nitinol-based and self-expanding, to choose from. [2345678] The use of coils has gained popularity due to the advantages of smaller and more flexible introducer sheaths, simple handling, and cost efficiency.…”

Patent ductus arteriosus and pulmonary arterial hypertension: Is it closer to closure?

“…The pulmonary artery pressure to aortic pressure ratio (PAP/Ao) was 0.86 at baseline and improved to 0.36 one year after PDA occlusion. There were no reported incidents of device embolization, hemolysis, residual shunt, or obstruction of the adjacent pulmonary artery or aorta .…”

“…In this issue of Catheterization and Cardiovascular Interventions , Lehner et al have reported the results of a single‐center retrospective study of 8 patients aged 4–16 years, weighing 14–56 kg, who underwent percutaneous occlusion of isolated large patent ductus arteriosus (PDA) in the setting of elevated pulmonary artery pressures. The investigators assessed the safety, efficacy, and technical feasibility of using the Occlutech PDA occluder in such patients.…”

“…After hemodynamic information was obtained, the decision was made to proceed with PDA occlusion despite the patients’ elevated pulmonary artery pressures (38–80 mm Hg). Shunt calculations with Qp:Qs and, consequently, resistance calculations were not performed because the authors were concerned about their validity and accuracy in large shunts . However, five patients underwent balloon occlusion to evaluate pulmonary artery pressure or ductal anatomy.…”