[Percutaneous closure of patent ductus arteriosus using the Amplatzer vascular Plug II]. / Cierre percutáneo del conducto arterioso permeable utilizando el Amplatzer vascular Plug II.

UNLABELLED: The Amplatzer vascular II Plug (AVPII) is a self- expanding occluder device, indicated for arterial and venous occlusion in the peripheral circulation. OBJECTIVE: To describe our initial clinical experience with the AVP II, in the percutaneous closure of small patent ductus arteriosus. METHOD: We retrospectively analyzed seven patients who underwent percutaneous closure of patent ductus arteriosus. The AVP II was chosen with a diameter greater than 50% of the minimum diameter of the ductus arteriosus. RESULTS: Patients showed a ductus arteriosus with a diameter of 1.5 ± 1.4 (range: 0.8 - 4.7 mm). Successful implant was achieved with adequate angiographic occlusion in 6 patients. One patient was sent to surgery. We only found a major complication. Transthoracic echocardiography at 24 hours, confirmed the complete occlusion in this patients. The follow-up was 10.6 ± 9.1 months. CONCLUSION: The AVP II in this group of patients was shown to be safe and effective for percutaneous closure of patent ductus arteriosus.

Cierre percutáneo del conducto arterioso permeable utilizando el Amplatzer vascular Plug II / Percutaneous closure of patent ductus arteriosus using the Amplatzer vascular Plug II

Amplatzer vascular Plug II (AVP II) es un dispositivo oclusor autoexpandible, indicado para oclusiones arteriales o venosas en la vasculatura periférica. Objetivo: Describir nuestra experiencia clínica inicial con el AVP II, en el cierre percutáneo del conducto arterioso permeable pequeño. Métodos: Analizamos retrospectivamente, siete pacientes sometidos a oclusión percutánea del conducto arterioso. El AVP II se eligió con un diámetro mayor a 50% del diámetro mínimo del conducto arterioso. Resultados: Los pacientes evidenciaron un conducto arterioso con un diámetro mínimo de 1.5 ± 1.4 (intervalo: 0.8 a 4.7mm). Se logró un implante exitoso y con adecuada oclusión angiográfica en seis pacientes. Un paciente fue enviado a cirugía. Sólo observamos una complicación mayor. El ecocardiograma transtorácico a las 24 horas, confirmó la oclusión completa en estos pacientes. El seguimiento fue de 10.6 ± 9.1 meses. Conclusiones: El AVP II, en este grupo de pacientes mostró ser seguro y efectivo para el cierre percutáneo del conducto arterioso.

The Amplatzer vascular Plug II (AVP II) is a self-expanding occluder device, indicated for arterial and venous occlusion in the peripheral circulation. Objective: To describe our initial clinical experience with the AVP II, in the percutaneous closure of small patent ductus arteriosus. Method: We retrospectively analyzed seven patients who underwent percutaneous closure of patent ductus arteriosus. The AVP II was chosen with a diameter greater than 50% of the minimum diameter of the ductus arteriosus. Results:Patients showed a ductus arteriosus with a diameter of 1.5 ± 1.4 (range: 0.8 - 4.7mm). Successful implant was achieved with adequate angiographic occlusion in 6 patients. One patient was sent to surgery. We only found a major complication. Transthoracic echocardiography at 24 hours, confirmed the complete occlusion in this patients. The follow-up was 10.6 ± 9.1 months. Conclusion: The AVP II in this group of patients was shown to be safe and effective for percutaneous closure of patent ductus arteriosus.

Transcatheter closure of patent ductus arteriosus using the amplatzer duct occluder in infants under 1 year of age.

INTRODUCTION AND OBJECTIVES: Percutaneous closure of patent ductus arteriosus (PDA) is a well-established technique. We evaluated the usefulness of the Amplatzer duct occluder for the percutaneous closure of patent ductus arteriosus in 29 children under 1 year of age. METHODS: The patients' mean age was 8.9+/-2.8 months and their mean weight was 6.4+/-1.5 kg. In addition, 24.1% of patients were aged 6 months or less and 17.2% weighed 5 kg or less. All completed follow-up (0.5-36 months). RESULTS: The minimum PDA diameter was 3.16+/-1.24 mm. The device was implanted successfully in 26 patients (89.6%). Failures were due to either the device migrating to the descending aorta, persistent moderate leakage, or to difficulty in the advancement of the device. No deaths were associated with the procedure. Three major complications occurred in two patients (10.3%). Aortography showed initial total occlusion in 65.5% of patients. At 3-month follow-up, total occlusion was observed in 96.1% of patients. Ultimately, closure was achieved successfully in 25 of the 29 patients (86.2%). During follow-up, four patients exhibited mild left pulmonary artery stenosis and one exhibited mild stenosis of the descending aorta. CONCLUSIONS: In children under 1 year of age, percutaneous closure of patent ductus arteriosus using an Amplatzer occluder was a safe and effective procedure. It is possible that improvements in the design of the occluder could decrease the complication rate.

Cierre transcatéter del conducto arterioso persistente con dispositivo de Amplatzer en niños menores de un año / Transcatheter closure of patent ductus arteriosus using the amplatzer duct occluder in infants under one year of age

Introducción y objetivos. El cierre percutáneo del conducto arterioso persistente (CAP) es una técnica bien establecida. Evaluamos la utilidad del oclusor de Amplatzer (ADO), en el cierre percutáneo del CAP en 29 niños menores de 1 año. Métodos. La edad de los pacientes fue de 8,9 ± 2,8 meses y el peso, 6,4 ± 1,5 kg. El 24,1% de los pacientes con edad ≤ 6 meses y el 17,2%, con peso ≤ 5 kg. Se realizó seguimiento en todos (0,5-36 meses). Resultados. El diámetro mínimo del conducto fue 3,16 ± 1,24 mm. El dispositivo se implantó con éxito en 26 (89,6%) pacientes. Las causas del fracaso se debieron a migración del dispositivo a la aorta descendente, persistencia de la fuga en forma moderada y dificultad en progresar el dispositivo. La mortalidad fue nula con el procedimiento. Ocurrieron 3 complicaciones mayores en 2 (10,3%) pacientes. Un aortograma mostró oclusión completa inicial en el 65,5% de los pacientes. La oclusión completa del conducto se demostró en el 96,1% de los pacientes al tercer mes de seguimiento. El éxito final del cierre del CAP se logró en 25/29 (86,2%) pacientes. En el seguimiento, 4 pacientes mostraron estenosis leve en la rama pulmonar izquierda, y 1, estenosis leve en la aorta descendente. Conclusiones. En niños menores de 1 año, el cierre percutáneo del CAP con el oclusor de Amplatzer es un procedimiento efectivo y seguro. Las mejoras en el diseño del oclusor posiblemente disminuirán la frecuencia de complicaciones (AU)

Introduction and objectives. Percutaneous closure of patent ductus arteriosus (PDA) is a well-established technique. We evaluated the usefulness of the Amplatzer duct occluder for the percutaneous closure of patent ductus arteriosus in 29 children under 1 year of age. Methods. The patients’ mean age was 8.9 [2.8] months and their mean weight was 6.4 [1.5] kg. In addition, 24.1% of patients were aged 6 months or less and 17.2% weighed 5 kg or less. All completed follow-up (0.5-36 months). Results. The minimum PDA diameter was 3.16[1.24] mm. The device was implanted successfully in 26 patients (89.6%). Failures were due to either the device migrating to the descending aorta, persistent moderate leakage, or to difficulty in the advancement of the device. No deaths were associated with the procedure. Three major complications occurred in two patients (10.3%). Aortography showed initial total occlusion in 65.5% of patients. At 3-month follow-up, total occlusion was observed in 96.1% of patients. Ultimately, closure was achieved successfully in 25 of the 29 patients (86.2%). During follow-up, 4 patients exhibited mild left pulmonary artery stenosis and 1 exhibited mild stenosis of the descending aorta. Conclusions. In children under 1 year of age, percutaneous closure of patent ductus arteriosus using an Amplatzer occluder was a safe and effective procedure. It is possible that improvements in the design of the occluder could decrease the complication rate (AU)

Transcatheter closure of patent ductus arteriosus using the amplatzer duct occluder in infants under one year of age.

INTRODUCTION AND OBJECTIVES: Percutaneous closure of patent ductus arteriosus (PDA) is a well-established technique. We evaluated the usefulness of the Amplatzer duct occluder for the percutaneous closure of patent ductus arteriosus in 29 children under 1 year of age. METHODS: The patients' mean age was 8.9±2.8 months and their mean weight was 6.4±1.5kg. In addition, 24.1% of patients were aged 6 months or less and 17.2% weighed 5kg or less. All completed follow-up (0.5-36 months). RESULTS: The minimum PDA diameter was 3.16±1.24 mm. The device was implanted successfully in 26 patients (89.6%). Failures were due to either the device migrating to the descending aorta, persistent moderate leakage, or to difficulty in the advancement of the device. No deaths were associated with the procedure. Three major complications occurred in two patients (10.3%). Aortography showed initial total occlusion in 65.5% of patients. At 3-month follow-up, total occlusion was observed in 96.1% of patients. Ultimately, closure was achieved successfully in 25 of the 29 patients (86.2%). During follow-up, four patients exhibited mild left pulmonary artery stenosis and one exhibited mild stenosis of the descending aorta. CONCLUSIONS: In children under 1 year of age, percutaneous closure of patent ductus arteriosus using an Amplatzer occluder was a safe and effective procedure. It is possible that improvements in the design of the occluder could decrease the complication rate.