Closure of wide patent ductus arteriosus using a fenestrated muscular VSD occluder device in a pediatric patient with Down syndrome and pulmonary hypertension

Abstract Ductus arteriosus is a physiological structure if not closed after birth, may lead to many complications. Today, trans-catheter closure of patent ductus arteriosus with Occluder devices is the preferred method. Surgical ligation is used only in certain cases such as large symptomatic patent ductus arteriosus in very small infants and premature babies; unfavourable structure of the duct or economic considerations. In this article, we described haemodynamic and morphological characteristics of five patients with large patent ductus arteriosus which were occluded with Amplatzer device. From 23 January, 2010 to 31 July, 2018, five patients referred to our clinic with large patent ductus arteriosus and pulmonary arterial hypertension for further evaluation. After assessing them with various diagnostic methods, we decided to close defect with ventricular septal defect Occluder device. Patients aged 21–44 years and one of them was male. Ductus closure was successfully done with ventricular septal defect Occluder device. Closure was successful for all of them but in one case, whose device was embolized to pulmonary artery after 24 hr and he underwent surgery. Trans-catheter closure of large patent ductus arteriosus in adult patients with pulmonary hypertension is feasible. Despite the fact that complications may occur even with the most experienced hands, the ‘double disk’ Amplatzer ventricular septal defect muscular Occluder could be advantageous in this setting.

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PATENT DUCTUS ARTERIOSUS WITH PULMONARY HYPERTENSION

Journal of Thoracic Surgery ◽

10.1016/s0096-5588(20)30922-3 ◽

1956 ◽

Vol 31 (3) ◽

pp. 268-285

Author(s):

F. Henry Ellis ◽

John W. Kirklin ◽

John A. Callahan ◽

Earl H. Wood

Keyword(s):

Pulmonary Hypertension ◽

Patent Ductus Arteriosus ◽

Ductus Arteriosus ◽

Patent Ductus

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Intracardiac and External Phonocardiographic Study in Infant with Patent Ductus Arteriosus and Pulmonary Hypertension

Japanese Circulation Journal ◽

10.1253/jcj.32.1571 ◽

1968 ◽

Vol 32 (11) ◽

pp. 1571-1577 ◽

Cited By ~ 1

Author(s):

HIROHISA KATO ◽

TEIICHI ODA ◽

MIZUO HIROSE ◽

YOSHIAKI YOSHIZAWA ◽

KAZUO URYU ◽

...

Keyword(s):

Pulmonary Hypertension ◽

Patent Ductus Arteriosus ◽

Ductus Arteriosus ◽

Patent Ductus

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Modern treatment of patent ductus arteriosus – single center experience

Journal of Health Sciences ◽

10.17532/jhsci.2014.212 ◽

2014 ◽

Vol 4 (3) ◽

pp. 181-185

Author(s):

Senka Mesihović Dinarević ◽

Almira Kadic ◽

Zijo Begić ◽

Mirza Halimić ◽

Emina Vukas

Keyword(s):

Patent Ductus Arteriosus ◽

Transcatheter Closure ◽

Ductus Arteriosus ◽

Length Of Hospital Stay ◽

Single Center Experience ◽

Pediatric Clinic ◽

Occluder Device ◽

Length Of Hospitalization ◽

Selection Of ◽

Patent Ductus

Introduction: Transcatheter closure is a treatment choice for the most children with patent ductus arteriosus (PDA). The closure of the ductus is indicated in any child or adolescent with developed symptoms of significant L-R shunt. The aim of this article is to present our results in 5 years treatment of patients with PDA and their outcome. Methods: From 2009 to 2014, 30 patients underwent a transcatheter closure of PDA at Centre for Heart and Pediatric clinic of Clinical University Centre of Sarajevo. Aortic angiogram was performed to evaluate the size, position, and shape of the duct for selection of appropriate occluder device type and size. All procedures were performed by local team of cardiologists from the Department of Cardiology, Pediatric clinic, with invasive cardiologists team from Sweden and Austria. Echocardiography was repeated at intervals of 24 hours, then 1month, 3 months, and 1 year after the procedure to assess the outcome. Results: Thirty patients underwent transcatheter closure of PDA during the study period. PDA of ≤ 2.0 mm was present in 8 patients and they underwent PDA closure with coils, while 22 patients had PDA diameter ≥ 2 mm, and they were treated by Amplatzer duct occluder (ADO). Only in 2 (6.2%) patients complications have been observed. The length of hospital stay after the treatment was two to three days. Conclusion: Transcatheter closure of PDA is a modern, safe and efficient method that ensures a faster recovery of the patients, shortens the length of hospitalization.

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MANAGEMENT OF HYPERTENSIVE PDA

Pakistan Armed Forces Medical Journal ◽

10.51253/pafmj.v70isuppl-4.6003 ◽

2021 ◽

Vol 70 (Suppl-4) ◽

pp. S701-05

Author(s):

Khushal Khan Khattak ◽

Maad Ullah ◽

Abdul Malik Sheikh ◽

Asma Kanwal ◽

Sajid Ali Shah ◽

...

Keyword(s):

Pulmonary Hypertension ◽

Pulmonary Artery ◽

Patent Ductus Arteriosus ◽

Palliative Treatment ◽

Ductus Arteriosus ◽

Treatment Options ◽

Device Closure ◽

Surgical Ligation ◽

Percutaneous Catheter ◽

Patent Ductus

Objective: To determine different treatment options in patients of Patent Ductus Arteriosus with pulmonary hypertension beyond neonatal period. Study Design: Descriptive cross sectional study. Place and Duration of Study: This study was carried out in Pediatric Cardiology department of Rawalpindi Institute of Cardiology, from Jan 2017 to Jan 2019. Methodology: Patients having PDA with pulmonary hypertension were included in the study. Treatment options were divided into percutaneous catheter device closure, surgical ligation of patent ductus arteriosus and palliative treatment. Any adverse event during the procedure was documented. Stratification was done in regard to gender and age group. Post stratification chi square test was applied and p-value less than or equal to 0.05 was considered as significant. Results: Total number of patients included in the study were 37. Mean age (years) of patients (Mean ± SD) was 19.21 ± 8.76. Mean ± SD pulmonary artery pressure was 56.43 ± 11.55 mmHg. Percutaneous catheter device closure was successful in 24 (64.9%) patients, in 7 (18.9%) patients primary surgical PDA ligation was done, 3 (8.1%) patients were advised palliative treatment and in 3 (8.1%) patients adverse events occurred during percutaneous device closure and were thus referred for surgical ligation. Patent ductus Arteriosus Occlutech device was used in 18 (48.6%) patients, Occlutech VSD device was used in 7 (18.5%) patients and in 1 (2.7%) patient AGA duct occluder was used. Conclusion: In patients with patent ductus arteriosus and pulmonary artery hypertension, percutaneous catheter device closure is a safe and effective procedure.

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Elongated Patent Ductus Arteriosus with Intermittent Shunting

PEDIATRICS ◽

10.1542/peds.39.3.446 ◽

1967 ◽

Vol 39 (3) ◽

pp. 446-448

Author(s):

COLETTE M. KOHLER ◽

DAN G. MCNAMARA

Keyword(s):

Pulmonary Hypertension ◽

Case Report ◽

Patent Ductus Arteriosus ◽

Premature Infants ◽

Ductus Arteriosus ◽

Cardiac Defects ◽

Cardiac Catheterizations ◽

Delayed Closure ◽

Patent Ductus

The presence of patent ductus arteriosus without a typical continuous murmur has long been recognized, especially in the presence of pulmonary hypertension, or a small ductus, or with associated cardiac defects; however, there are only a few reports of documented, intermittently disappearing murmurs occurring in individuals over 6 months of age with a substantial shunt in the absence of pulmonary hypertension or associated defects. Danilowicz, et al. have recently reported delayed closure of the ductus anteriosus up to 6 months of age in some premature infants. We present this case report of a 2½-year-old boy with patent ductus arteriosus with cardiac catheterizations during the disappearance and subsequent reappearance of a continuous murmur with documentation of absence of shunting when the murmur was absent and substantial shunting if the murmur was present.

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