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Use of Amplatzer vascular plugs and Amplatzer duct occluder II additional sizes for occlusion of patent ductus arteriosus: A multi‐institutional study
Author(s) -
VanLoozen Dennis,
Sandoval Juan Pablo,
Delaney Jeffrey W.,
Pedra Carlos,
Calamita Paulo,
Dalvi Bharat,
Kenny Damien,
Cleary Aoife,
Amin Zahid
Publication year - 2018
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.27824
Subject(s) - medicine , ductus arteriosus , embolization , stenosis , occlusion , surgery , complication , pulmonary artery , shunt (medical) , cardiology
Background Variable patent ductus arteriosus (PDA) morphology and the need to close PDAs in small size patients has led physicians to use Amplatzer Vascular Plugs (AVP) and recently available Amplatzer Duct Occluder II ‐ Additional Sizes (ADO II AS). The purpose of this study was to analyze the safety, efficacy, and complication rates of the ADO II AS and AVPs, specifically AVP II. Methods All patients undergoing PDA closure with an AVP or ADO II AS from 2011 to 2016 were included. Clinical, echocardiographic, and angiographic data were collected and reviewed. Results Four hundred and sixty‐nine patients were included. Median age was 27 months (0.75–852) and the median weight was 11.4 kg (1–92). There were 51 patients ≤5 kg. Type A PDA was most common in 48% ( n = 225), followed by type E (27.5%, n = 129), type D (13%, n = 61), type C (10.2%, n = 48), and type B (1.3%, n = 6). Devices included AVP II ( n = 421), ADO II AS ( n = 30), and AVP IV ( n = 18), left pulmonary artery stenosis occurred in 4.3% ( n = 20). One patient required surgery for severe stenosis; the remaining cases were mild and required no intervention. Device embolization occurred in 3 patients (10%) with the ADO II AS. Successful device closure was achieved in 98.9% of cases. Conclusions The AVP II was highly effective for closing PDAs in smaller babies with varying morphologies and is safe when used in small sized patients with relatively low risk of complications. More studies are warranted to clarify the risks of ADO II AS.