Trans-catheter closure of large PDA in adult patients with Amplatzer device: case series

Abstract

Ductus arteriosus is a physiological structure if not closed after birth, may lead to many complications. Today, trans-catheter closure of patent ductus arteriosus with Occluder devices is the preferred method. Surgical ligation is used only in certain cases such as large symptomatic patent ductus arteriosus in very small infants and premature babies; unfavourable structure of the duct or economic considerations. In this article, we described haemodynamic and morphological characteristics of five patients with large patent ductus arteriosus which were occluded with Amplatzer device. From 23 January, 2010 to 31 July, 2018, five patients referred to our clinic with large patent ductus arteriosus and pulmonary arterial hypertension for further evaluation. After assessing them with various diagnostic methods, we decided to close defect with ventricular septal defect Occluder device. Patients aged 21–44 years and one of them was male. Ductus closure was successfully done with ventricular septal defect Occluder device. Closure was successful for all of them but in one case, whose device was embolized to pulmonary artery after 24 hr and he underwent surgery. Trans-catheter closure of large patent ductus arteriosus in adult patients with pulmonary hypertension is feasible. Despite the fact that complications may occur even with the most experienced hands, the ‘double disk’ Amplatzer ventricular septal defect muscular Occluder could be advantageous in this setting.

Case report: Thoracic endovascular aortic repair using a non-touch exclusion technique with a custom-made device for the treatment of a large patent ductus arteriosus

“…However, this alternative option has not been approved by the Food and Drug Administration for large PDAs, and results have not been satisfactory in some case series. Additionally, there are some potential disadvantages, such as residual shunting in PDAs with some anatomical features, which may make this option inappropriate for certain patients ( 9 ).…”

The Patent Ductus Arteriosus in Adults with Special Focus on Role of CT

“…This was done using an Ivalon plug with an 18 F catheter [ 24 ]. Since then, there have been remarkable advances in the technique for transcatheter closure of PDAs [ 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ], and evolution is continuing with the following aims for the closure device: (1) making the device with material compatible with MRI; (2) conforming it to the full spectrum of PDA sizes and shapes; (3) permitting it to be safely delivered with a sheath of small diameter; (4) allowing free retrievability of the device; (5) crafting a device that will permanently occlude the PDA. Closure by an interventional occluder device is the primary therapeutic choice in infants, children, and adults with a small or moderate size symptomatic PDA [ 1 , 11 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 ].…”