Surgical Therapy for Patent Arterial Duct and Vascular Rings

AbstractAimOur aim was to review the outcome of ligation of the persistently patent arterial duct in neonates as performed outside a paediatric cardiothoracic centre by an outreach surgical team.MethodsA retrospective observational study of all ligations of the persistently patent arterial duct performed in Cambridge between January, 1988, and December, 2002.ResultsOver the period of 15 years studied, a persistently patent arterial duct was ligated in 43 neonates. The median gestational age at birth was 26 weeks, with a range from 23 to 35 weeks, and median weight at birth was 722 grams, with a range from 500 to 2100 grams. Median age at ligation, was 25 days, with a range from 10 to 89 days, and their weight was 963 grams, with a range from 568 to 2221 grams. Ligation was successful in 42 babies (98%), mortality at 30 days of 5%, and 29 of the babies (67%) surviving to be discharged from the hospital. The late deaths were due to complications of prematurity, rather than the procedure of ligation.ConclusionThe persistently patent arterial duct can successfully be ligated by an outreach surgical team outside a paediatric cardiothoracic centre. There was an excellent 30 day survival.

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Transcatheter closure of elongated and pulmonary hypertensive patent arterial duct in infants using Amplatzer vascular plug II

Cardiology in the Young ◽

10.1017/s1047951120000104 ◽

2020 ◽

Vol 30 (2) ◽

pp. 243-248 ◽

Cited By ~ 1

Author(s):

Sneha M. Jain ◽

Priya M. Pradhan ◽

Supratim Sen ◽

Bharat V. Dalvi

Keyword(s):

Pulmonary Artery ◽

Amplatzer Vascular Plug ◽

Successful Outcome ◽

Pulmonary Artery Stenosis ◽

Amplatzer Duct Occluder ◽

Vascular Plug ◽

Arterial Duct ◽

Duct Diameter ◽

Patent Arterial Duct ◽

Amplatzer Vascular Plug Ii

AbstractObjective:To evaluate the feasibility, efficacy, and safety of Amplatzer vascular plug II in large and elongated ducts in infants.Introduction:Patent arterial duct device closure is technically challenging in infants with large and elongated ducts because Amplatzer duct occluder and Amplatzer duct occluder II have high chances of causing aortic coarctation and left pulmonary artery stenosis, respectively. The Amplatzer vascular plug II being soft with no retention discs on either sides helps in mitigating these problems.Method:This is a prospective, observational study involving infants with clinical, echocardiographic and angiographic evidence of large left to right shunt. All the children underwent duct closure using Amplatzer vascular plug II.Results:Eighteen infants qualified for the study. Mean age and weight were 8.63 ± 3.84 months and 6.3 ± 1.7 kg, respectively. The angiographic mean duct diameter at the pulmonary artery end was 4.66 ± 0.92 mm, and the mean duct length was 9.4 ± 2.48 mm. The size of Amplatzer vascular plug II used varied from 6 mm to 10 mm. Technical success was achieved in 16/18 cases. One patient had device embolisation, and in the other, the device was found to be unstable. The ratio of Amplatzer vascular plug II size to the duct diameter was 1.65 ± 0.27, while the ratio of ductal length to device length was 1.48 ± 0.46 in those with successful outcome.Conclusions:Amplatzer vascular plug II is a safe and effective option in appropriately selected infants with elongated ducts. Diameter and length of Amplatzer vascular plug II vis-a-vis those of the ductus are important determinants of the successful outcome.

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Closure of a patent arterial duct in a septuagenarian with atrial fibrillation

Cardiology in the Young ◽

10.1017/s1047951104003142 ◽

2004 ◽

Vol 14 (3) ◽

pp. 328-329 ◽

Cited By ~ 2

Author(s):

Konrad Brockmeier ◽

Peter Hallscheidt ◽

Christlieb Haller

Keyword(s):

Atrial Fibrillation ◽

Amplatzer Duct Occluder ◽

Residual Shunt ◽

Arterial Duct ◽

Patent Arterial Duct

We occluded a large arterial duct in a patient with atrial fibrillation, using an Amplatzer duct occluder, with no residual shunt at the end of the procedure. Follow-up revealed recanalization, which was successfully treated with a 4 mm Amplatzer ASD occluder. It is speculated the reopening of the initially occluded duct was the consequence of anticoagulation needed because of the atrial fibrillation.

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Unexpected ischemia during transcatheter patent arterial duct closure

Cardiology in the Young ◽

10.1017/s104795111900218x ◽

2019 ◽

Vol 29 (11) ◽

pp. 1410-1411

Author(s):

Ondrej Materna ◽

Vojtech Suchanek ◽

Oleg Reich

Keyword(s):

Coronary Artery ◽

Delivery System ◽

Right Ventricular Outflow Tract ◽

Ventricular Outflow Tract ◽

Single Coronary Artery ◽

Posterior Aspect ◽

Inferior Caval Vein ◽

Arterial Duct ◽

The Right ◽

Patent Arterial Duct

AbstractA child undergoing routine transcatheter patent arterial duct closure developed severe transient ischemic changes in the electrocardiogram (Pardee waves) while the aortic retention skirt of the Amplatzer™ Duct Occluder was pulled against the duct orifice. The occluder was then released, and the delivery system was pulled back to inferior caval vein which led to electrocardiogram normalisation. Aortic root angiography showed a single coronary artery originating from the right sinus of Valsalva with the left coronary stem wedged behind the posterior aspect of the right ventricular outflow tract. We believe that the left coronary artery was compressed while applying tension on the occluder delivery system.

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Two Rare Vascular Rings With Ductal Origin of the Left Pulmonary Artery: A Previously Unrecognized Syndrome?

World Journal for Pediatric and Congenital Heart Surgery ◽

10.1177/2150135116675166 ◽

2016 ◽

Vol 9 (3) ◽

pp. 352-356

Author(s):

Poonam P. Thankavel ◽

Kristine J. Guleserian ◽

Robert H. Anderson

Keyword(s):

Pulmonary Artery ◽

Aortic Arch ◽

Clinical Course ◽

Left Pulmonary Artery ◽

Descending Aorta ◽

Vascular Rings ◽

Arterial Duct

We report two neonates with distal ductal origin of the left pulmonary artery who also had rare vascular rings comprised of a left aortic arch and right arterial duct with a midline/rightward descending aorta. To the best of our knowledge, this association has not previously been described, although other abnormalities of the left pulmonary artery in the setting of vascular rings have been reported. We review the embryology, utility of imaging, and clinical course.

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Percutaneous closure of a patent arterial duct in a newborn

Cardiology in the Young ◽

10.1017/s1047951109004132 ◽

2009 ◽

Vol 19 (4) ◽

pp. 400-402

Author(s):

Fredy H. Prada ◽

Juan M. Carretero ◽

Lorenzo Jimenez

Keyword(s):

Critically Ill ◽

Atrioventricular Block ◽

Multiorgan Failure ◽

Percutaneous Closure ◽

Amplatzer Duct Occluder ◽

Complete Atrioventricular Block ◽

Arterial Duct ◽

Critically Ill Neonates ◽

Patent Arterial Duct ◽

Complete Atrioventricular

AbstractWe report a successful percutaneous neonatal closure of haemodynamically significant patent arterial duct. The neonate was suffering multiorgan failure, and had complete atrioventricular block. Closure of the patent arterial duct, either with surgery or inhibitors of cyclooxygenase, was contraindicated. We inserted the Amplatzer Duct Occluder II, showing that percutaneous closure of a patent arterial duct is now feasible in critically ill neonates.

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