Transcatheter closure of calcified patent ductus arteriosus in older adult patients: Immediate and 12-month follow-up results

Gu, Xiang; Zhang, Qiuwang; Sun, Honggang; Fei, Jianchun; Zhang, Xiquan; Kutryk, Michael J.B.

doi:10.1111/chd.12437

Cited by 9 publications

(8 citation statements)

References 13 publications

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“…is is a well-described difficulty among elderly patients with PDA [3,18] and, as in our cohort, more frequently appears among calcified ducts.…”

Section: Discussionsupporting

confidence: 68%

“…Residual shunts and haemolysis are more frequently found in percutaneously closed calcified ducts [3]. However, a small residual shunt in only one patient at follow-up (VSO, calcified duct) and no case of haemolysis were found in our analysis.…”

Section: Discussioncontrasting

confidence: 54%

“…With the development of coils and nitinol wire mesh duct occluders, percutaneous closure has become the method of choice in PDA treatment, also in this age group. However, the literature concerning transcatheter closure of PDA in elderly patients, especially those with a calcified duct, is scarce [3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

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Transcatheter Closure of Patent Ductus Arteriosus in Elderly Patients: Initial and One-Year Follow-Up Results—Do We Have the Proper Device?

Gałeczka

Szkutnik

Białkowski

et al. 2020

Journal of Interventional Cardiology

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Objectives. Patent ductus arteriosus (PDA) in elderly patients is an uncommon anomaly, and the duct itself is often calcified and fragile; therefore, transcatheter closure is more difficult. The aim is to analyse periprocedural and one-year follow-up results of transcatheter closure of PDA in such patients. Methods and results. Retrospective analysis of 33 elective patients aged ≥55 years (median 63; 56–85; 29 women), in whom PDA was closed percutaneously between 2002 and 2018 in two tertiary centres. All but three patients were symptomatic, with most in NYHA II (n = 14) and III (n = 11) class; pulmonary hypertension (n = 22), arterial hypertension (n = 22), duct calcifications (n = 17), atrial fibrillation (n = 15), significant mitral regurgitation (n = 5), and decompensated renal failure (n = 2) were observed. Different devices were applied depending on PDA morphology; nitinol wire mesh occluders with symmetrical articulating discs have been the most used in recent years (n = 11). Follow-up was conducted at an outpatient clinic (28/33 patients). The procedure was successful in all patients. There was one embolisation, followed by implantation of a larger device. No major complications were noted. A small residual shunt was present in echocardiography in one patient after one year. NYHA class improved in all but two patients (with multiple comorbidities). Conclusions. Transcatheter PDA closure in elderly patients is safe and efficient with a high complete closure rate and few complications. Amplatzer duct occluder type II is an attractive device in such patients.

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“…is is a well-described difficulty among elderly patients with PDA [3,18] and, as in our cohort, more frequently appears among calcified ducts.…”

Section: Discussionsupporting

confidence: 68%

Section: Discussioncontrasting

confidence: 54%

See 1 more Smart Citation

Transcatheter Closure of Patent Ductus Arteriosus in Elderly Patients: Initial and One-Year Follow-Up Results—Do We Have the Proper Device?

Gałeczka

Szkutnik

Białkowski

et al. 2020

Journal of Interventional Cardiology

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“…IVUS precisely revealed that calcification was around 180 at the aortic side. The size of the occluder we selected was twice that of the narrowest portion of the PDA, which was acceptable based on a previous report [5]. Surgical findings and a contrast computed tomography scan after urgent surgery clearly showed an intramural hematoma and that the dissection cavity started from the periphery of the device; therefore, the device was suspected to be related to this event.…”

Section: Discussionmentioning

confidence: 94%

Acute ascending aortic dissection due to transcatheter patent ductus arteriosus closure in the elderly: An extremely rare complication of transcatheter patent ductus arteriosus closure

Yamamoto

Shinke

Otake

et al. 2019

Journal of Cardiology Cases

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“…Wider and longer PDA and B/D type-PDA may necessitate longer procedural/fluoroscopic times. 4,7) Calcification reduces duct elasticity, leading to difficulty in using the antegrade approach (passing the catheter from the pulmonary artery to the descending aorta), and, thus, a retrograde approach (wire-assisted technique) is sometimes needed, leading to longer procedural/fluoroscopic times 14) : one patient in the study group needed it. Even with this background, the study group showed shorter fluoroscopic/procedural times, which may suggest that the 3D model made the procedure easier.…”

Section: Discussionmentioning

confidence: 99%

A Patient-Specific Hollow Three-Dimensional Model for Simulating Percutaneous Occlusion of Patent Ductus Arteriosus

Matsubara¹,

Kataoka²,

Takahashi

et al. 2019

Int. Heart J.

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Percutaneous catheter closure of patent ductus arteriosus (PDA) is difficult when the ductus is large and long or shows calcification. We created a patient-specific 3-dimensional (3D) model for PDA, with which we simulated device deployment, thereby selecting the device/size in a patient-by-patient manner. We assessed whether this 3D model is effective for catheter PDA closure. The 3D model was created in this institute, requiring 3 days and 90 US dollars. After its introduction, 7 consecutive patients (the study group) with severe PDA underwent closure with the aid of the 3D model. The control group consisted of 4 patients before 3D-model introduction, with all having severe PDA: the requirement of computed tomography was considered a criterion of severe or difficult-procedure-requiring PDA. In all study group patients, the devices/sizes could be pre-selected based on the simulation, whereas devices were changed during the procedure in 2 of 4 in the control group. In the study group, compared with the control group, the fluoroscopic (median 31 [interquartile range of 16-42] versus 39 [19-71] minutes, respectively) and total procedural times (median 107 [interquartile range 67-114] versus 124 [78-184] minutes, respectively) were shorter. A questionnaire confirmed the doctors' understanding of the procedure. This 3D model may be effective for percutaneous catheter closure of PDA. This may be especially true in cases of severe or difficult-procedure-requiring PDA.

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Transcatheter closure of calcified patent ductus arteriosus in older adult patients: Immediate and 12-month follow-up results

Abstract: Successful closure of calcified PDA with few complications in older adult patients was achieved using the duct occluder.

Cited by 9 publications

References 13 publications

Transcatheter Closure of Patent Ductus Arteriosus in Elderly Patients: Initial and One-Year Follow-Up Results—Do We Have the Proper Device?

Transcatheter Closure of Patent Ductus Arteriosus in Elderly Patients: Initial and One-Year Follow-Up Results—Do We Have the Proper Device?

Acute ascending aortic dissection due to transcatheter patent ductus arteriosus closure in the elderly: An extremely rare complication of transcatheter patent ductus arteriosus closure

A Patient-Specific Hollow Three-Dimensional Model for Simulating Percutaneous Occlusion of Patent Ductus Arteriosus

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