Transcatheter closure of patent ductus arteriosus with the Rashkind occluder: Acute results and angiographic follow-up in adults

Background: Patent Ductus Arteriosus (PDA) is a common congenital disorder. As an isolated lesion, PDA constitutes 6 to 11% of all congenital heart disease. PDA needs closure to eliminate pulmonary over circulation leading to volume overload of left ventricle, pulmonary vascular obstructed disease.Methods: This retrospective study was carried out in pediatric cardiology unit of Institute of Postgraduate Medical Education and Research, Kolkata from September 2005 to August 2016, which included 503 patients.Results: Device closure was attempted in 492 patient’s Procedural success was achieved in 85% cases on table, in who check aortogram revealed complete closure of PDA. In 15% cases, residual shunt was present. In 12% of cases, residual shunt disappeared during follow-up echocardiogram over 6-month follow-up. In 3% cases, small shunt remained at 6-month and 1-year follow up.Conclusion: Transcatheter closure of PDA by duct occluder is safe and effective with good mid-term outcome. The optimum assessment of ductul size and anatomy is crucial for optimum device size, which prevents residual shunt, device embolization and protrusion.

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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?

Journal of Interventional Cardiology ◽

10.1155/2020/4585124 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8 ◽

Cited By ~ 1

Author(s):

Michal Galeczka ◽

Malgorzata Szkutnik ◽

Jacek Bialkowski ◽

Sebastian Smerdzinski ◽

Mateusz Knop ◽

...

Keyword(s):

Elderly Patients ◽

Patent Ductus Arteriosus ◽

Transcatheter Closure ◽

Nyha Class ◽

Ductus Arteriosus ◽

Wire Mesh ◽

Residual Shunt ◽

One Year ◽

Patent Ductus

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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Faculty Opinions recommendation of Transcatheter Closure of Patent Ductus Arteriosus in Extremely Premature Newborns: Early Results and Midterm Follow-Up.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.727094177.793543944 ◽

2018 ◽

Author(s):

Lee Benson

Keyword(s):

Patent Ductus Arteriosus ◽

Transcatheter Closure ◽

Ductus Arteriosus ◽

Premature Newborns ◽

Early Results ◽

Patent Ductus

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Abstract 16481: Feasibility and Safety of Transcatheter Closure of Patent Ductus Arteriosus in Infants Weighing <700 Grams

Circulation ◽

10.1161/circ.142.suppl_3.16481 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Abhishek Chakraborty ◽

Ranjit Philip ◽

Rush Waller ◽

Ronak Naik ◽

Mimily Harsono ◽

...

Keyword(s):

Patent Ductus Arteriosus ◽

Premature Infants ◽

Transcatheter Closure ◽

Ductus Arteriosus ◽

Human Beings ◽

Average Birth Weight ◽

Single Center Study ◽

Procedural Complications ◽

Patent Ductus

Introduction: Recently, the Amplatzer Piccolo Occluder (APO) was approved for PDA closure for infants weighing > 700 grams. The feasibility and safety of the procedure for anyone below this weight cut-off has not been previously explored. Hypothesis: Transcatheter closure of patent ductus arteriosus (PDA) in premature infants who weigh < 700 grams at the time of the procedure is safe and feasible. Methods: This is a retrospective, single-center, study to explore the outcomes of transcatheter PDA occlusions performed on infants weighing < 700 grams. Results: A total of 18 patients weighing between 540 and 670 grams (mean = 612.8 grams) were identified to have underwent the procedure between the two centers. The gestational age ranged between 22-26 weeks (median 24 weeks), and the average birth weight was 537.5 grams. The mean age at the time of PDA closure was 20 days (range 8-35 days). The implant success rate was 100%. The devices used included the MVP-5Q (N=8), the 3-2 APO (N=5) and the 4-2 APO (N=5). The procedure time was 26 ± 23 minutes and fluoroscopy time was 3.7 ± 3.1 minutes. One patient, weighing 640 grams required chest compressions for resuscitation following the procedure, but recovered and since then has grown normally to hospital discharge. There were no other procedural complications. At the latest follow-up (median 1-year), there have been four non-survivors, all unrelated to the procedure. Conclusions: It is feasible and likely safe to perform transcatheter closure of patent ductus arteriosus (PDA) in premature infants who weigh < 700 grams using currently available technologies. There is a learning curve with these interventions. Extreme care must be taken while performing interventions in such small human beings. Further miniaturization of equipment would facilitate better outcomes.

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