Safety and Procedural Success of Transcatheter Closure of Patent Ductus Arteriosus in Adults at Shahid Gangalal National Heart Centre, Kathmandu, Nepal

Background and Aims: Transcatheter closure of patent ductus arteriosus (PDA) using either coils or device is a well-established procedure. PDA is one of the common congenital heart diseases and it is not uncommon for it to be diagnosed in adulthood. However, only few studies are conducted in our part of the world regarding the safety and procedural success of device closure of PDA in adults. We aim to assess safety and procedural success of transcatheter closure of PDA in adults at Shahid Gangalal National Heart Centre, Kathmandu, Nepal. Methods: It was a single center, retrospective study. Cardiac catheterization laboratory records of all consecutive adult patients (age ≥ 18 years) who underwent PDA device closure between March 2007 to March 2020 were reviewed. Patients age, gender, device size and device type along with procedural success of the procedure were reviewed. Any complication recorded was reviewed. Results: During the study period 118 adult patients were attempted for transcatheter closure of PDA. In three cases transcatheter closure was not attempted. In one patients attempt was made to close the duct with cook coil which embolized to pulmonary artery. PDA was successfully closed in 114 patients. Among the 114 patients, 87 were females and 27 were male. Age ranged from 18 to 69 years with mean age was 29.5 years. PDA size ranged from 3mm to 18mm with the mean of 6.9mm. In two patients, residual PDA after surgical closure were closed. Amplatzer duct occluder was the most commonly used device used in 89 (78%) patients followed by Memopart PDA device in 11 (9.6%) patients, Amplatzer Muscular VSD occluder in four patients. Device size of “8x10” in 32 patients and “10x12” device in 29 patients, were the most commonly used device size. Conclusion: Transcatheter closure of PDA in adults can safely be done with high success rate.

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Transcatheter closure of Patent ductus arteriosus at Shahid Gangalal National Heart Centre, Kathmandu, Nepal

Journal of Advances in Internal Medicine ◽

10.3126/jaim.v6i1.18310 ◽

2017 ◽

Vol 6 (1) ◽

pp. 1-3

Author(s):

Chandra Mani Adhikari ◽

Rabi Malla ◽

Urmila Shakya ◽

Manish Shrestha ◽

Binay Rauniyar ◽

...

Keyword(s):

Patent Ductus Arteriosus ◽

Transcatheter Closure ◽

Ductus Arteriosus ◽

Lateral View ◽

Catheterization Laboratory ◽

Transcatheter Occlusion ◽

Cardiac Catheterization Laboratory ◽

National Heart ◽

Device Deployment ◽

Patent Ductus

Background and Aims: In the current era, transcatheter closure of patent ductus arteriosus (PDA) using either coils or device is a well-established procedure. The aim of this study was to assess safety of transcatheter closure of PDA at Shahid Gangalal national heart Centre, Kathmandu, Nepal.Methods: It was a single centre, retrospective study conducted between March 2007 to March 2017. Cardiac catheterization laboratory records of all consecutive patients who underwent PDA device closure were included. A lateral view Aortic angiogram was performed to determine the morphology and size of the duct. Device type and size was selected as per the aortogram. A second aortic angiogram was performed 5 min after device deployment to determine the success of the closure. Echocardiography was done next day of the procedure to assess success of the closure.Result: During the study period 126 patients were attempted for transcatheter closure of PDA. Six patient were thought to have unfavorable size or shape, and transcatheter occlusion was not attempted. In one patients attempt was made to close the duct with cook coil which embolized to pulmonary artery. One hundred and nineteen patient PDA was successfully closed. Among the 119 patients 89 were female and 30 were male. The PDA was closed by Amplatzer duct occluder in 99 patients, Life tech PDA occluder in 14 patients, Hyperion PDA occluder in two patients, Post-infarct Muscular VSD Occluder in four patients.Conclusions: Transcatheter closure of PDA can be done safely with high success rate.

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Intravascular ultrasonography-guided measurement and transcatheter closure of highly calcified patent ductus arteriosus in an older adult

Cardiology in the Young ◽

10.1017/s1047951121002250 ◽

2021 ◽

pp. 1-3

Author(s):

Yoko Kawai ◽

Takeshi Nakamura ◽

Satoaki Matoba

Keyword(s):

Older Adults ◽

Patent Ductus Arteriosus ◽

Older Adult ◽

Transcatheter Closure ◽

Ductus Arteriosus ◽

Ct Images ◽

Device Closure ◽

Intravascular Ultrasonography ◽

Patent Ductus

Abstract In older adults with patent ductus arteriosus, CT is widely used for duct visualisation because angiography images can be inadequate for evaluation. We report the case of a 73-year-old woman with a highly calcified patent ductus arteriosus whose CT images were insufficient for accurate measurement. Intravascular ultrasonography is useful for sizing of and guiding device closure of the duct.

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Device closure of patent ductus arteriosus: analysis of cases in a Bangladeshi centre

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20202573 ◽

2020 ◽

Vol 7 (7) ◽

pp. 1481

Author(s):

Nurun N. Fatema ◽

Abul K. M. Razzaque

Keyword(s):

Patent Ductus Arteriosus ◽

Transcatheter Closure ◽

Ductus Arteriosus ◽

Age Groups ◽

Device Closure ◽

Catheterization Laboratory ◽

Congenital Rubella ◽

First Choice ◽

Associated Conditions ◽

Patent Ductus

Background: Transcatheter closure of Patent ductus arteriosus (PDA) has become the first-choice therapy for closure in patients of any age group. Authors reviewed the outcome of device closure in all age groups starting from neonate to adult.Methods: From December 2014 to December 2019, 440 cases underwent transcatheter closure in a catheterization laboratory of a tertiary level cardiac hospital. Selection criteria were isolated PDA or PDA with associated conditions which can be managed in the same setting by an intervention. Exclusion criteria were proven Eisenmenger syndrome. A retrospective review of outcome and complications were recorded from computerized data records.Results: Age of the patient varied from 10 days to 65 years. The median age was 3 years. Most of the patients were female (63%), weight varied from 1.8 kg to 75 kg. the median weight was 7.5 kg. Isolated PDA cases were 74.77 %. Among syndromes, congenital rubella syndrome was common (7.5%), followed by Down Syndrome (6.36%). The narrowest PDA diameter varied for 1.8 mm - 14 mm with a median of 5 mm. Among duct occluders, 8x6 mm CeraTM was the commonest one used in the study population. Complete occlusion was observed in 99.55% of cases.Conclusions: Transcatheter closure of PDA is considered safe and efficacious in all age groups. It is the gold standard now and replaced surgical option in most of the places.

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Hemolysis and its outcome following percutaneous closure of cardiac defects among children and adolescents: a prospective study

Italian Journal of Pediatrics ◽

10.1186/s13052-019-0728-5 ◽

2019 ◽

Vol 45 (1) ◽

Author(s):

Hamid Amoozgar ◽

Romeileh Soltani ◽

Mohammadreza Edraki ◽

Nima Mehdizadegan ◽

Hamid Mohammadi ◽

...

Keyword(s):

Ventricular Septal Defect ◽

Patent Ductus Arteriosus ◽

Septal Defect ◽

Transcatheter Closure ◽

Ductus Arteriosus ◽

Residual Flow ◽

Intravascular Hemolysis ◽

Device Closure ◽

Residual Shunt ◽

Patent Ductus

Abstract Background Transcatheter closure of intracardiac defects might be complicated by intravascular hemolysis. We evaluated hemolysis and its outcome after transcatheter closure of these defects. Methods and patients All patients who underwent transcatheter closure of patent ductus arteriosus, ventricular septal defect and atrial septal defect were included in this prospective study. Clinical data were obtained before and after the catheterization. Results One hundred and thirty-eight patients were enrolled; and four (3%) patients developed intravascular hemolysis; while two cases had residual shunt and two other cases had not residual flow. Although residual shunt occurred in ten patients, only 2 of these cases developed hemolysis. Patent ductus arteriosus closure was done for one of these cases and the other one, underwent perimembranous ventricular septal defect closure. Moreover, hemolysis occurred after device closure of patent ductus arteriosus in 2 of the other patients with no residual shunt. In this study the hemolysis was eliminated by conservative management within 2 weeks although residual shunt continued in this time. We observed a decline in lactate dehydrogenase value after catheterization in comparison with precatheterization, which was mainly among ventricular septal defect patients that might be due to mild chronic hemolysis in these patients. Conclusion Incidence of hemolysis after device closure was low, and occurred with and without residual flow and was eliminated by conservative management in 2 weeks, without the need for surgery, although the residual shunt was continued.

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Transcatheter closure of patent ductus arteriosus using duct occluder: an eleven-year experience from a single tertiary cardiac center

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20193141 ◽

2019 ◽

Vol 7 (8) ◽

pp. 2894

Author(s):

Achyut Sarkar ◽

Neha Rani ◽

Prashant Kumar ◽

Shyam Sundar Chaudhary ◽

Suman Chatterjee

Keyword(s):

Patent Ductus Arteriosus ◽

Transcatheter Closure ◽

Postgraduate Medical Education ◽

Ductus Arteriosus ◽

Volume Overload ◽

Residual Shunt ◽

Term Outcome ◽

Procedural Success ◽

Patent Ductus

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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Results of U.S. phase I and II clinical trials of transcatheter closure of patent ductus arteriosus in adult patients using the amplatzerfi duct occlud

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(03)80938-5 ◽

2003 ◽

Vol 41 (6) ◽

pp. 75

Author(s):

Tom Hong ◽

Ziyad M. Hijazi ◽

William E. Hellenbrand ◽

John P. Cheatham ◽

Zahid Amin ◽

...

Keyword(s):

Clinical Trials ◽

Patent Ductus Arteriosus ◽

Phase I ◽

Transcatheter Closure ◽

Ductus Arteriosus ◽

Adult Patients ◽

Patent Ductus ◽

Phase I And Ii

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Ductal arterial spasm: a nightmare

Cardiology in the Young ◽

10.1017/s1047951119003238 ◽

2020 ◽

Vol 30 (3) ◽

pp. 422-423

Author(s):

Hnin L. Phyu ◽

Khin M. Oo

Keyword(s):

Patent Ductus Arteriosus ◽

Transcatheter Closure ◽

Ductus Arteriosus ◽

Catheter Intervention ◽

Device Closure ◽

Arterial Spasm ◽

Percutaneous Device ◽

Device Selection ◽

Percutaneous Device Closure ◽

Patent Ductus

AbstractDuctal arterial spasm is a very potentially dangerous incidence during percutaneous device closure of patent ductus arteriosus (PDA), which, otherwise, is a very safe catheter intervention. It is essential to notice its occurrence before device sizing and deploying. Without awareness, it can mislead device selection and can result in serious complication. In this report, we shared our nightmare of ductal spasm during transcatheter closure of PDA in two children which had led to death in one patient.

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Percutaneous device closure of patent ductus arteriosus in adult patients with 10-year follow-up

Heart Views ◽

10.4103/heartviews.heartviews_21_19 ◽

2019 ◽

Vol 20 (4) ◽

pp. 139

Author(s):

Wail Alkashkari ◽

Saad Albugami ◽

Jamilah Alrahimi ◽

Mohammed Althobaiti ◽

Abdulhalim Kinsara ◽

...

Keyword(s):

Patent Ductus Arteriosus ◽

Ductus Arteriosus ◽

Adult Patients ◽

Device Closure ◽

Percutaneous Device ◽

Percutaneous Device Closure ◽

Patent Ductus

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Feasibility and Safety of Percutaneous Cardiac Interventions for Congenital and Acquired Heart Defects in Infants ≤1000 g

Children ◽

10.3390/children8090826 ◽

2021 ◽

Vol 8 (9) ◽

pp. 826

Author(s):

Ranjit Philip ◽

Jeffrey Towbin ◽

Neil Tailor ◽

Vijaya Joshi ◽

Jason N. Johnson ◽

...

Keyword(s):

Adverse Event ◽

Patent Ductus Arteriosus ◽

Congenital Heart Defects ◽

Congenital Heart ◽

Transcatheter Closure ◽

Heart Defects ◽

Ductus Arteriosus ◽

Major Adverse Event ◽

Procedural Success ◽

Patent Ductus

The transcatheter closure of patent ductus arteriosus (TCPC) has been demonstrated to be feasible even in infants weighing ≤1000 g. However, other percutaneous cardiac interventions (PCI) for such small infants born with congenital heart defects (CHD) or acquired heart defects (AHD) have not been well described. The purpose of this study was to describe the feasibility and safety of PCI in infants ≤1000 g. A retrospective review was conducted between June 2015 and May 2021, looking at 148 consecutive PCIs performed on infants weighing ≤1000 g at the time of the procedure. The procedural success rate was 100%. The major adverse event (AE) rate for TCPC was 3%, while there were no major AEs for other PCI. It is feasible to perform PCIs in infants weighing ≤1000 g with CHD and AHD using currently available technologies.

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