Midterm Results of Transcatheter Closure of Moderate to Large-sized Patent Ductus Arteriosus Using the Amplatzer Duct Occluder

摘要

Transcatheter closure is an established form of treatment for most patients with patent ductus arteriosus (PDA). The design of previously used devices has been associated with several drawbacks for closing moderate to large PDAs. The aim of this study was to examine the midterm results of transcatheter closure of moderate to large-sized PDA using the Amplatzer Duct Occluder (ADO). Ninety patients, aged 2.9 months to 16.5 years with a moderate to large-sized PDA, underwent successful transcatheter closure using the ADO. The median PDA diameter was 2.8 mm (range 1.5 to 5.0 mm). Complete immediate angiographic closure was seen in 34 of 90 patients (37.7%; 95% CI 27.7% to 47.7%). On colour Doppler interrogation, the closure rates at 1 day, 1 month and 3 months after implant were 81.1% (95% CI 73.0% to 89.2%), 88.9% (95% CI 82.5% to 95.3%) and 93.3% (95% CI 88.1% to 98.5%) respectively. At 12 months, all patients had complete closure. The median fluoroscopy time was 11.5 minutes (range 3 to 49.5 minutes) and the median procedure time was 68 minutes (range 32 to 180 minutes). Mild devicerelated turbulent blood flow but with no significant obstruction occurred in the left pulmonary artery of two patients and the descending aorta of another patient who had pre-existing isthmal hypoplasia. No device embolisation was encountered. Therefore transcatheter closure of moderate to large-sided PDA using the ADO is an effective and safe therapy. Further studies are required to establish long-term results in a larger patient population.