Der Verschluß des Ductus arteriosus persistens ohne Thorakotomie<sup>***</sup>(2. Mitteilung)

Porstmann, W; Wierny, L; Warnke, H

doi:10.1055/s-0029-1228429

Cited by 45 publications

(14 citation statements)

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“…Porstmann et al first advocated a percutaneous technique for permanent closure of the arterial duct, which could be achieved via the femoral artery, in the late 1960s, but this technique was not widely used. 80,81 Closure was accomplished with an Ivalon (polyvinyl alcohol) plug introduced by catheterization from the femoral artery. The 1980s were witness to a virtual explosion of catheter-based therapy.…”

Section: Catheter-based Therapy In Congenital Heart Diseasementioning

confidence: 99%

Pediatric Cardiology and Cardiovascular Surgery: 1950-2000

Freedom

Lock²,

Bricker³

2000

Circulation

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Section: Catheter-based Therapy In Congenital Heart Diseasementioning

confidence: 99%

Pediatric Cardiology and Cardiovascular Surgery: 1950-2000

Freedom

Lock²,

Bricker³

2000

Circulation

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“…9 Then the disk occluder of Rashkind and Cuaso was reported in 1979 10 and in 1991 a buttoned device was used. 11 However, all these devices required relatively large sheaths and so were not suitable for young or small patients.…”

Section: Discussionmentioning

confidence: 99%

Conservative Treatment of Hemolytic Complication Following Coil Embolization in Two Adult Cases of Patent Ductus Arteriosus.

et al. 2001

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oil embolization has been recently used for closure of patent ductus arteriosus (PDA), but because large PDA are difficult to close with this technique, it is generally used when the duct diameter is less than 3.5 mm. 1 However, there are some case reports in which large PDA were closed by placing more than 2 coils. 2,3 Serious complications of coil embolization are coil migration and hemolysis caused by a residual shunt, 4,5 the latter being reported as the major complication with approximately 1-2% occurrence. 2,6,7 Although a hemolytic complication usually needs additional coil embolization 4,5 or surgical treatment, medical treatment may be preferable when the residual shunt is minimal and the degree of hemolysis is mild. We report 2 cases of large PDA that were treated by multiple coil embolization, complicated by hemolysis, but successfully managed by medical treatment. Case Reports Case 1A 67-year-old woman was admitted for evaluation of dyspnea on exersion, paroxysmal atrial fibrillation (AF), and a continuous murmur of grade 4/6 in the second left intercostal space. Physical examination revealed blood pressure of 120/60 mmHg under medical treatment. The ECG finding was left ventricular hypertrophy with ST-T abnormality. Chest X-ray (CXR) showed moderate cardiomegaly with increased pulmonary vascular markings. Color Doppler echocardiography showed a shunt flow in the pulmonary artery. Right heart catheterization revealed the pulmonary artery pressure was 30/14 mmHg and there was an oxygen step-up at the level of the main pulmonary artery. The ratio of pulmonary to systemic flow was 2.0. Aortography revealed the shunt flow and a type A PDA 8 with a minimum ductal diameter of 5.3 mm. Left ventriculography showed an increase in ventricular volume, but the ventricular wall motion and coronary angiogram were normal.Because the ductal diameter was relatively large to be closed by embolization with one coil, we planned to deliver multiple Jackson detachable coils (MWCE-8-PDA5; diameter 8 mm and 5 loops, Cook Cardiology, Bjaeverskov, Denmark). Two 7Fr catheters were inserted into the femoral vein and advanced from the pulmonary artery through the Two adult cases of relatively large patent ductus arteriosus (PDA) were treated by coil embolization, but were complicated by hemolysis that was successfully managed by medical treatment. Case 1 was a 67-year-old woman and Case 2 was a 71-year-old woman with a PDA of minimal diameter of 5.3 mm and 5.5 mm, respectively. The approach was via the pulmonary artery and 2 coils were delivered simultaneously into the ductus, known as the 'kissing coil technique'. Although immediately after the procedure only a small residual shunt was revealed by aortogram, hemolysis occurred for several hours after the procedure in both cases. A hemolytic complication usually needs additional coil embolization or surgical treatment, but in these 2 cases it was successfully treated by haptoglobin infusion to prevent nephropathy and by antiplasmin infusion to promote thrombus formation. Hemolyt...

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“…Since the first successful transcatheter closure of patent ductus arteriosus (PDA) by Porstmann in 1967 [1,2], several different PDA closure devices have been developed and evaluated. Today, percutaneous closure of almost any PDA beyond neonatal age can be easily and safely performed using detachable coils or specifically designed occluders, including different generations of the Amplatzer Duct Occluder (ADO I, II, and AS) [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

The Occlutech Duct Occluder for Patent Ductus Arteriosus

Hanna¹,

Charbel²,

Chehab³

et al. 2017

jshd

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Objective: To describe our experience in percutaneous patent ductus arteriosus (PDA) closure using the Occlutech Duct Occluder (ODO). Methods: We retrospectively reviewed records of patients who underwent a PDA closure attempt using the ODO between August 2013 and October 2015. Only patients with isolated PDA and weighing ≥6 kg were eligible for ODO use. Results: Eighteen ODO devices were successfully implanted in 18 patients. Patient age and weight ranged from 6 to 180 months (median, 23.5 months) and 6 to 54 kg (median, 11 kg), respectively. PDAs were of type A (n = 16), type E (n = 1), or type D (n = 1). PDA diameter ranged from 2 to 5 mm (median, 3 mm). Median procedure time was 55 min (range, 35-105 min). Median fluoroscopy time was 9.2 min (range, 3.0-29.6 min). The device diameter (pulmonary end) was 5-8 mm (median, 7 mm). The standard shank length was used in 13 cases, and the long variant was used in five cases. Median follow-up period was 12 months. All devices were successfully implanted. Total occlusion was achieved the following day in all but two patients, in whom it was confirmed one month later. No major complications occurred. Mild pulmonary obstruction was noted in one patient, and aortic disc bulging occurred in two patients without hemodynamic consequences. Conclusion: In this group of patients, the ODO showed excellent results in terms of safety and efficacy. The long device variant may be advantageous in some large and long PDAs. Larger case series are needed to compare the ODO with preexisting devices.

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Der Verschluß des Ductus arteriosus persistens ohne Thorakotomie^***(2. Mitteilung)

Cited by 45 publications

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Pediatric Cardiology and Cardiovascular Surgery: 1950-2000

Pediatric Cardiology and Cardiovascular Surgery: 1950-2000

Conservative Treatment of Hemolytic Complication Following Coil Embolization in Two Adult Cases of Patent Ductus Arteriosus.

The Occlutech Duct Occluder for Patent Ductus Arteriosus

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Der Verschluß des Ductus arteriosus persistens ohne Thorakotomie***(2. Mitteilung)

Cited by 45 publications

References 0 publications

Pediatric Cardiology and Cardiovascular Surgery: 1950-2000

Pediatric Cardiology and Cardiovascular Surgery: 1950-2000

Conservative Treatment of Hemolytic Complication Following Coil Embolization in Two Adult Cases of Patent Ductus Arteriosus.

The Occlutech Duct Occluder for Patent Ductus Arteriosus

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Der Verschluß des Ductus arteriosus persistens ohne Thorakotomie^***(2. Mitteilung)