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Transcatheter closure of coronary artery fistulae using the Amplatzer duct occluder
Author(s) -
Behera Sarina K.,
Da Saar,
Levi Daniel S.,
Moore John W.
Publication year - 2006
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.20811
Subject(s) - medicine , palpitations , surgery , shunt (medical) , occlusion , cardiac catheterization , fistula , cardiology , heart failure
Objective: The aim of this study is to report our experience using the Amplatzer Duct Occluder (ADO) for occlusion of significant coronary artery fistulae (CAF). Background: Transcatheter closure of CAF with coils is well described. Use of newer devices may offer advantages such as improved control of device placement, use of a single instead of multiple devices, and high rates of occlusion. Methods: A retrospective review of all patients catheterized for CAF from July 2002 through August 2005 was performed. Results: Thirteen patients with CAF underwent cardiac catheterization, of which a total of 6 patients had ADO placement in CAF (age, 21 days to 56 years; median age, 4.3 years and weight, 3.8 kg to 74.6 kg; median weight, 13.3 kg). An arteriovenous wire loop was used to advance a long sheath antegrade to deploy the ADO in the CAF. Immediate and short‐term outcomes (follow‐up, 3 months to 14 months; median follow‐up, 8.5 months) demonstrated complete CAF occlusion in 5 patients and minimal residual shunt in 1 patient (who had resolution of right atrial and right ventricular enlargement). On follow‐up clinical evaluation, all 6 patients had absence of fistula‐related murmurs, and 2 previously symptomatic patients had resolution of congestive heart failure symptoms. Early complications included transient palpitations and atrial arrhythmia in the 2 oldest patients (52 and 56 years old). Conclusions: Use of the ADO is applicable for transcatheter closure of significant CAF. Advantages of using the ADO include the antegrade approach, use of a single device, and effective CAF occlusion. © 2006 Wiley‐Liss, Inc.