Interventional cardiology surgery
Transcatheter closure of persistent ductus arteriosus in infants
using the Amplatzer duct occluder
G Fischer, J Stieh, A Uebing, R Grabitz, H H Kramer
Department of
Paediatric Cardiology and Biomedical Engineering, Christian Albrechts
University of Kiel, Schwanenweg 20, D-24105 Kiel, Germany
Correspondence to: Dr Fischer fischer{at}pedcard.uni-kiel.de
Accepted 29 May 2001
AIM
To evaluate whether transcatheter
closure with the Amplatzer duct occluder offers an alternative to
surgical treatment in infants with a persistent ductus arteriosus.
METHODS12 patients under 1 year of age (age 1-11 months, body weight 2.6-8.7 kg) with clinical
and echocardiographic findings of a significant duct were considered
for transcatheter closure with the Amplatzer occluder. The device is
made of a Nitinol and polyester fabric mesh and provides occlusion
by stenting the duct. Measured angiographically, the narrowest diameter
of the ducts ranged from 1.5-5 mm; in six patients pulmonary
hypertension was also present.
RESULTSThe devices were implanted
and complete duct occlusion was demonstrated during follow up in 10 patients. Procedure related difficulties occurred in nine of the 12 cases and led to relatively long procedure and fluoroscopy times
(procedure time 50-180 minutes, median 80 minutes; fluoroscopy time
4.9-49 minutes, median 16 minutes). In two infants transcatheter
closure could not be achieved and surgical duct ligation had to be
carried out.
CONCLUSIONSIn small infants with a
persistent ductus arteriosus the Amplatzer duct occluder offers an
alternative to surgical treatment, but further improvement of the
implantation system is necessary before the procedure can be
recommended as the treatment of choice.
Keywords: persistent ductus arteriosus; transcatheter closure; infants; Amplatzer duct occluder
© 2001 by Heart
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