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Baspinar O, Narin N, Baykan A, Yildiz K, Pamukcu O, Ozyurt A, Kervancioglu M, Kum YE, Temel MT, Dogan A, Bagli S, Demircan T, Aydin Sahin D, Elmali F, Karadeniz C. Piccolo in transcatheter PDA closure multi-centre study from premature to adolescent children. Cardiol Young 2024; 34:157-162. [PMID: 37283091 DOI: 10.1017/s1047951123001385] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
In this multi-centre study, the mid- to long-term efficacy and safety of the Amplatzer Piccolo Occluder in patent ductus arteriosus closure in premature and term infants as well as children were discussed. Methods. Between 2016 and 2021, 645 patients, 152 of whom were less than 1 month old, underwent ductus closure with the Piccolo device from five different centres in Turkey. The median age of the patients was 2.2 years, and the mean narrowest point of duct diameter was 1.8 mm. Sixty-two patients weighed ≤ 1.5 kg, 90 patients 1.5-3 kg, and the mean follow-up was 20.4 months. In 396, the duct was closed by the retrograde route. Ductal anatomy was Type A in 285, C in 72, E in 171, and F in 64 patients. Fluoroscopy duration was 6.2 min. The procedure success rate was 99.1%. Device embolisation occurred in 13 patients (2%), and 11 were retrieved with a snare. Cardiac perforation and death developed in one premature baby. The left pulmonary artery and the descending aorta stenosis were observed in 3 (0.4%) and in 5 patients (0.5%). Results. Piccolo device is safe and effective in closing ductus in all age groups. It has low profile for use in premature and newborn babies, a small embolisation risk, and a low residual shunt rate after closure. Conclusion. The Piccolo device can be considered as close an ideal occluder. The lower profile, smaller delivery catheter size, and symmetry of this device allow for a venous or arterial approach.
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Affiliation(s)
- Osman Baspinar
- Pediatric Cardiology, Gaziantep University Medical Faculty, Gaziantep, Turkey
| | - Nazmi Narin
- Pediatric Cardiology, Izmir Katip Celebi University Medical Faculty, Izmir, Turkey
| | - Ali Baykan
- Pediatric Cardiology, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Kaan Yildiz
- Pediatric Cardiology, Tepecik Training and Research Hospital Clinics, İzmir, Turkey
| | - Ozge Pamukcu
- Pediatric Cardiology, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Abdullah Ozyurt
- Pediatric Cardiology, Mersin Women's and Children's Hospital, Mersin, Turkey
| | - Mehmet Kervancioglu
- Pediatric Cardiology, Gaziantep University Medical Faculty, Gaziantep, Turkey
| | - Yunus Emre Kum
- Pediatric Cardiology, Erciyes University Medical Faculty, Kayseri, Turkey
| | | | - Alper Dogan
- Pediatric Cardiology, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Sedat Bagli
- Pediatric Cardiology, Tepecik Training and Research Hospital Clinics, İzmir, Turkey
| | - Tulay Demircan
- Pediatric Cardiology, Tepecik Training and Research Hospital Clinics, İzmir, Turkey
| | - Derya Aydin Sahin
- Pediatric Cardiology, Gaziantep University Medical Faculty, Gaziantep, Turkey
| | - Ferhan Elmali
- Biostatistics Department. Izmir Katip Celebi University, Izmir, Turkey
| | - Cem Karadeniz
- Pediatric Cardiology, Tepecik Training and Research Hospital Clinics, İzmir, Turkey
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Bruckheimer E, Steiner K, Barak-Corren Y, Slanovic L, Levinzon M, Lowenthal A, Amir G, Dagan T, Birk E. The Amplatzer duct occluder (ADOII) and Piccolo devices for patent ductus arteriosus closure: a large single institution series. Front Cardiovasc Med 2023; 10:1158227. [PMID: 37215550 PMCID: PMC10193946 DOI: 10.3389/fcvm.2023.1158227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 04/10/2023] [Indexed: 05/24/2023] Open
Abstract
Purpose Evaluate Piccolo and ADOII devices for transcatheter patent ductus arteriosus (PDA) closure. Piccolo has smaller retention discs reducing risk of flow disturbance but residual leak and embolization risk may increase. Methods Retrospective review of all patients undergoing PDA closure with an Amplatzer device between January 2008 and April 2022 in our institution. Data from the procedure and 6 months follow-up were collected. Results 762 patients, median age 2.6 years (range 0-46.7) years and median weight 13 kg (range 3.5-92) were referred for PDA closure. Overall, 758 (99.5%) had successful implantation: 296 (38.8%) with ADOII, 418 (54.8%) with Piccolo, and 44 (5.8%) with AVPII. The ADOII patients were smaller than the Piccolo patients (15.8 vs. 20.5 kg, p < 0.001) and with larger PDA diameters (2.3 vs. 1.9 mm, p < 0.001). Mean device diameter was similar for both groups. Closure rate at follow-up was similar for all devices ADOII 295/296 (99.6%), Piccolo 417/418 (99.7%), and AVPII 44/44 (100%). Four intraprocedural embolizations occurred during the study time period: two ADOII and two Piccolo. Following retrieval the PDA was closed with an AVPII in two cases, ADOI in one case and with surgery in the fourth case. Mild stenosis of the left pulmonary artery (LPA) occurred in three patients with ADOII devices (1%) and one patient with Piccolo device (0.2%). Severe LPA stenosis occurred in one patient with ADOII (0.3%) and one with AVPII device (2.2%). Conclusions ADOII and Piccolo are safe and effective for PDA closure with a tendency to less LPA stenosis with Piccolo. There were no cases of aortic coarctation related to a PDA device in this study.
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Affiliation(s)
- Elchanan Bruckheimer
- Section of Pediatric Cardiology, Schneider Children’s Medical, Center of Israel, Petach Tikva, Israel
| | - Kristoffer Steiner
- Section of Pediatric Cardiology, Schneider Children’s Medical, Center of Israel, Petach Tikva, Israel
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Yuval Barak-Corren
- Section of Pediatric Cardiology, Schneider Children’s Medical, Center of Israel, Petach Tikva, Israel
| | - Leonel Slanovic
- Section of Pediatric Cardiology, Schneider Children’s Medical, Center of Israel, Petach Tikva, Israel
| | - Michael Levinzon
- Section of Pediatric Anesthesiology, Schneider Children’s, Medical Center of Israel, Petach Tikva, Israel
| | - Alexander Lowenthal
- Section of Pediatric Cardiology, Schneider Children’s Medical, Center of Israel, Petach Tikva, Israel
| | - Gabriel Amir
- Section of Pediatric Cardiology, Schneider Children’s Medical, Center of Israel, Petach Tikva, Israel
| | - Tamir Dagan
- Section of Pediatric Cardiology, Schneider Children’s Medical, Center of Israel, Petach Tikva, Israel
| | - Einat Birk
- Section of Pediatric Cardiology, Schneider Children’s Medical, Center of Israel, Petach Tikva, Israel
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Bhat YA, Almesned A, Alqwaee A, Al Akhfash A. Catheter Closure of Clinically Silent Patent Ductus Arteriosus Using the Amplatzer Duct Occluder II-Additional Size: A Single-Center Experience. Cureus 2021; 13:e17481. [PMID: 34589368 PMCID: PMC8465329 DOI: 10.7759/cureus.17481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2021] [Indexed: 11/30/2022] Open
Abstract
Objectives Transcatheter closure is the treatment of choice for most patent ductus arteriosus (PDA) in infants, children, and adults. However, there is a controversy regarding transcatheter closure of clinically silent PDAs. Some authors favor device closure to eliminate the lifelong risk of infective endarteritis while others recommend avoiding PDA closure in such patients. The study describes our experience of closing the silent PDAs using the Amplatzer duct occluder II-additional size (ADO II-AS) (St. Jude Medical Corp, St. Paul, MN). Materials and methods From April 2018 through March 2021, 52 consecutive pediatric patients aged 18 years and less with clinically silent PDA who had transcatheter closure at our center were enrolled. Patients were excluded if they had clinically detected PDAs; had surgical ligation of PDA with no residual shunt; had left heart dilatation on echocardiography; or moderate-sized PDAs closed with ADO II-AS. In addition, patients with an innocent murmur or murmur due to an associated lesion were included. This study was retrospective, and all of the 52 patients underwent PDA device closure using ADO II-AS. Results Fifty-two consecutive patients were enrolled with a median age of 17 months, range (97-2.5) 94.5 months. Mean weight was 11.29 kilogram, range (24.8-3.5) 21.3 kilogram, and mean follow-up was 13.5 months, range (29-0) 29 months. Thirty-one (59.6%) were females, and 21 (40.4%) were males. The mean procedure time was 30.6 min, range (60-10) 50 min, and mean fluoroscopic time was 5.5 min, range (28-1.7) 26.3 min. The mean volume of contrast given was 9.1 milliliter, range (30-4) 26 milliliter. Forty-five (45; 88.2%) patients had immediate closure of PDA. No patients had anesthetic or vascular complications; however, two patients had procedural complications. Device placement was unsuccessful in one patient with Downs syndrome. The mean follow-up for our patients was 13.5 months, range (29-0) 29 months; the patients were asymptomatic at the follow-up, and none of the patients had any residual leak. None of the patients showed coarctation or left pulmonary artery stenosis at the latest follow-up. Conclusion The usefulness of catheter-based therapy for silent PDA is less well-established by current evidence. Further studies are needed to justify the intervention solely based on the premise that the silent duct is a substrate for infective endarteritis; however, our reason to close silent PDA was to do so primarily because of social reasons. This study found that device closure of silent PDA is safe and effective using an ADO II-AS device with minimal risk of embolization and a low residual shunt rate. Coils have been used to close small PDAs, however, with higher rates of embolization and device malpositioning. We believe ADO-II AS offers an advantage of safety and efficacy over coils. In addition, the study highlights the advantage of using an ADO II-AS device, which can be delivered via a four French delivery system with no arterial complications.
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Affiliation(s)
- Yasser A Bhat
- Department of Pediatric Cardiology, Prince Sultan Cardiac Centre, Buraidah, SAU
| | | | - Abdullah Alqwaee
- Department of Pediatric Cardiology, Prince Sultan Cardiac Centre, Buraidah, SAU
| | - Ali Al Akhfash
- Department of Pediatric Cardiology, Prince Sultan Cardiac Centre, Buraidah, SAU
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Sathanandam SK, Gutfinger D, O'Brien L, Forbes TJ, Gillespie MJ, Berman DP, Armstrong AK, Shahanavaz S, Jones TK, Morray BH, Rockefeller TA, Justino H, Nykanen DG, Zahn EM. Amplatzer Piccolo Occluder clinical trial for percutaneous closure of the patent ductus arteriosus in patients ≥700 grams. Catheter Cardiovasc Interv 2020; 96:1266-1276. [PMID: 32433821 PMCID: PMC7754477 DOI: 10.1002/ccd.28973] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 04/23/2020] [Accepted: 05/04/2020] [Indexed: 01/08/2023]
Abstract
Objectives Characterize the safety and effectiveness of the Amplatzer Piccolo Occluder for patent ductus arteriosus (PDA) closure. Background The presence of a hemodynamically significant PDA has been associated with an increased risk of morbidity and mortality in children born premature. Methods This was a single arm, prospective, multicenter, non‐randomized study to evaluate the Amplatzer Piccolo Occluder to treat PDA in patients ≥700 g. From June 2017 to February 2019, 200 patients were enrolled at nine centers, with 100 patients weighing ≤2 kg. Primary effectiveness endpoint was the rate of PDA closure at 6‐month follow‐up. Primary safety endpoint was the rate of major complications through 6 months. Secondary endpoint was rate of significant pulmonary or aortic obstruction through 6 months' follow‐up. Results The implant success rate was 95.5% (191/200) overall and 99% in patients ≤2 kg (99/100). The primary effectiveness endpoint was achieved in 99.4% of implanted patients. Four patients experienced a primary safety endpoint event (2 transfusions, 1 hemolysis, and 1 aortic obstruction). There were no branch pulmonary artery obstructions. Five patients, all ≤2 kg, were noted to have worsening of tricuspid regurgitation (TR) after the procedure. None of the TR incidences manifested clinically. The Amplatzer Piccolo Occluder received FDA approval in January 2019 and became the first device approved for PDA closure in patients ≥700 g. Conclusions This study supports the safety and effectiveness of the Amplatzer Piccolo Occluder, particularly in patients between 700 g and 2 kg where there is currently a significant unmet need in the United States. ClinicalTrials.gov identifier: NCT03055858.
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Affiliation(s)
- Shyam K Sathanandam
- LeBonheur Children's Hospital, University of Tennessee, Memphis, Tennessee, USA
| | - Dan Gutfinger
- Abbott Structural Heart, Santa Clara, California, USA
| | - Laura O'Brien
- Abbott Structural Heart, Santa Clara, California, USA
| | | | | | | | | | | | | | | | | | | | | | - Evan M Zahn
- Cedars-Sinai Medical Center, Los Angeles, California, USA
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5
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Mahmoud HT, Santoro G, Gaio G, D'Aiello FA, Capogrosso C, Palladino MT, Russo MG. Single-center experience in percutaneous closure of arterial duct with Amplatzer duct Occluder II additional sizes. Catheter Cardiovasc Interv 2016; 89:1045-1050. [DOI: 10.1002/ccd.26860] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2016] [Revised: 10/12/2016] [Accepted: 10/16/2016] [Indexed: 11/07/2022]
Affiliation(s)
- Heba Talat Mahmoud
- Department of Paediatric Cardiology, A.O.R.N. “Ospedali dei Colli”; 2nd University of Naples; Naples Italy
| | - Giuseppe Santoro
- Department of Paediatric Cardiology, A.O.R.N. “Ospedali dei Colli”; 2nd University of Naples; Naples Italy
| | - Gianpiero Gaio
- Department of Paediatric Cardiology, A.O.R.N. “Ospedali dei Colli”; 2nd University of Naples; Naples Italy
| | - Fabio Angelo D'Aiello
- Department of Paediatric Cardiology, A.O.R.N. “Ospedali dei Colli”; 2nd University of Naples; Naples Italy
| | - Cristina Capogrosso
- Department of Paediatric Cardiology, A.O.R.N. “Ospedali dei Colli”; 2nd University of Naples; Naples Italy
| | - Maria Teresa Palladino
- Department of Paediatric Cardiology, A.O.R.N. “Ospedali dei Colli”; 2nd University of Naples; Naples Italy
| | - Maria Giovanna Russo
- Department of Paediatric Cardiology, A.O.R.N. “Ospedali dei Colli”; 2nd University of Naples; Naples Italy
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6
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Ferraro G, Marini D, Agnoletti G. Off-label use of the amplatzer ductal occluder II additional size for percutaneous treatment of acute aortic occlusion in a baby. Catheter Cardiovasc Interv 2016; 89:E26-E29. [DOI: 10.1002/ccd.26619] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 05/10/2016] [Accepted: 05/14/2016] [Indexed: 11/08/2022]
Affiliation(s)
- G. Ferraro
- Department of Cardiology; Città Della Salute; Turin Italy
| | - D. Marini
- Department of Cardiology; Città Della Salute; Turin Italy
| | - G. Agnoletti
- Department of Cardiology; Città Della Salute; Turin Italy
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7
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Baspinar O, Sahin DA, Sulu A, Irdem A, Gokaslan G, Sivasli E, Kilinc M. Transcatheter closure of patent ductus arteriosus in under 6 kg and premature infants. J Interv Cardiol 2015; 28:180-9. [PMID: 25832591 DOI: 10.1111/joic.12196] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 02/28/2015] [Accepted: 03/05/2015] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Transcatheter closure of a patent ductus arteriosus (PDA) has always been considered risky for infants weighing <6 kg and preterms. We present our findings regarding transcatheter closures of PDA. METHODS The inclusion criteria were a weight of <6 kg and the presence of PDA symptoms. The study subjects were divided into two groups: <6 kg and premature infants. RESULTS A total of 69 infants were included. The mean ages and weights of the <6 kg and the preterms were 5.4 ± 2.7 months and 30.3 ± 19.9 days, and 4.6 ± 0.8 and 1.7 ± 0.3 kg, respectively. Type C PDAs were most frequently observed in the premature group, and type A was in <6 kg. Sixteen of the patients were premature infants, and 81.2% of them had an extremely low birth weight. All of the premature infants had comorbidities, and had been receiving respiratory support therapy. Transcatheter closure was successfully completed in 81.2% of the premature infants and 94.3% of the <6-kg infants. Major complications occurred in 4 patients (one death and three device embolizations). The patient's age was found to be the main risk factor. The most frequently used device was the Amplatzer duct occluder II in additional sizes (84.6%) in the preterms and the Amplatzer duct occluder I (34%) and II (34%) in the <6-kg group. CONCLUSION The transcatheter closure of PDA is relatively safe and effective in preterms and in infants <6 kg. The selection of a suitable device based on the type of PDA is critical to the success of the procedure.
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Affiliation(s)
- Osman Baspinar
- Department of Pediatric Cardiology, Gaziantep University, Medical Faculty,, Gaziantep, Turkey
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8
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GARAY FRANCISCOJ, AGUIRRE DANIEL, CÁRDENAS LUIS, SPRINGMULLER DANIEL, HEUSSER FELIPE. Use of the Amplatzer Vascular Plug II Device to Occlude Different Types of Patent Ductus Arteriosus in Pediatric Patients. J Interv Cardiol 2015; 28:198-204. [DOI: 10.1111/joic.12188] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
| | | | - LUIS CÁRDENAS
- Hospital de Niños Dr. Luis Calvo Mackenna; Santiago Chile
| | | | - FELIPE HEUSSER
- Hospital Clínico de la Universidad Católica de Chile; Santiago Chile
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9
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Interventioneller Verschluss eines persistierenden Ductus arteriosus. Monatsschr Kinderheilkd 2014. [DOI: 10.1007/s00112-014-3179-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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10
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Baykan A, Narin N, Özyurt A, Argun M, Pamukçu Ö, Onan SH, Sezer S, Baykan Z, Üzüm K. Do we need a femoral artery route for transvenous PDA closure in children with ADO-I? Anatol J Cardiol 2014; 15:242-7. [PMID: 25333978 PMCID: PMC5337062 DOI: 10.5152/akd.2014.5269] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The standard procedure in percutaneous closure of patent ductus arteriosus (PDA) with Amplatzer duct occluder-I (ADO-I) is transvenous closure guided by aortic access through femoral artery. The current study aims to compare the procedures for PDA closure with ADO-I: only transvenous access with the standard procedure. METHODS This study was designed retrospectively and 101 pediatric patients were included. PDA closure was done by only femoral venous access in 19 of them (group 1), arterial and venous access used in 92 patients (group 2) between 2004 to 2012 years. The position of the device and residual shunt in group1 was evaluated by the guidance of the aortogram obtained during the return phase of the pulmonary artery injection and guidance of transthoracic echocardiography. Shapiro-Wilk's test, Mann-Whitney U, chi-squared tests were used for statistical comparison. RESULTS The procedure was successful in 18 (95%) patients in group 1 and 90 (98%) patients in group 2. Complications including the pulmonary artery embolization (n=1), protrusion to pulmonary artery (n=1), inguinal hematoma (n=3), bleeding (n=2) were only detected in group 2. In other words, while complications were observed in 7 (7.2%) patients in group 2, no minor/major complication was observed in group 1. Complete closure in group 1 was: in catheterization room 14 (77.8%), at 24th hour in 2 (11.1%), at first month in 2 (11.1%). Complete closure in group 2 was: 66 (73.4%) patients in the catheterization room, 21 (23.3%) at 24th hour, 3 (3.3%) at first month, complete closure occurred at the end of first month. CONCLUSION In percutaneouse PDA closure via ADO-I, this technique can be a choice for patients whose femoral artery could not be accessed, or access is impossible/contraindicated. But for the reliability and validity of this method, randomized multicenter clinical studies are necessary.
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Affiliation(s)
- Ali Baykan
- Department of Peadiatric Cardiology, Faculty of Medicine, Erciyes University; Kayseri-Turkey.
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11
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Bruckheimer E, Godfrey M, Dagan T, Levinzon M, Amir G, Birk E. The Amplatzer duct occluder II additional sizes device for transcatheter PDA closure: Initial experience. Catheter Cardiovasc Interv 2014; 83:1097-101. [DOI: 10.1002/ccd.25445] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2013] [Revised: 12/28/2013] [Accepted: 02/08/2014] [Indexed: 11/06/2022]
Affiliation(s)
- Elchanan Bruckheimer
- Section of Pediatric Cardiology; Schneider Children's Medical Center of Israel; Petach Tikva Israel
| | - Max Godfrey
- Section of Pediatric Cardiology; Schneider Children's Medical Center of Israel; Petach Tikva Israel
| | - Tamir Dagan
- Section of Pediatric Cardiology; Schneider Children's Medical Center of Israel; Petach Tikva Israel
| | - Michael Levinzon
- Section of Pediatric Anesthesiology; Schneider Children's Medical Center of Israel; Petach Tikva Israel
| | - Gabriel Amir
- Section of Pediatric Cardiothoracic Surgery; Schneider Children's Medical Center of Israel; Petach Tikva Israel
| | - Einat Birk
- Section of Pediatric Cardiology; Schneider Children's Medical Center of Israel; Petach Tikva Israel
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12
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Baruteau AE, Hascoët S, Baruteau J, Boudjemline Y, Lambert V, Angel CY, Belli E, Petit J, Pass R. Transcatheter closure of patent ductus arteriosus: past, present and future. Arch Cardiovasc Dis 2014; 107:122-32. [PMID: 24560920 DOI: 10.1016/j.acvd.2014.01.008] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Revised: 01/15/2014] [Accepted: 01/20/2014] [Indexed: 11/29/2022]
Abstract
This review aims to describe the past history, present techniques and future directions in transcatheter treatment of patent ductus arteriosus (PDA). Transcatheter PDA closure is the standard of care in most cases and PDA closure is indicated in any patient with signs of left ventricular volume overload due to a ductus. In cases of left-to-right PDA with severe pulmonary arterial hypertension, closure may be performed under specific conditions. The management of clinically silent or very tiny PDAs remains highly controversial. Techniques have evolved and the transcatheter approach to PDA closure is now feasible and safe with current devices. Coils and the Amplatzer Duct Occluder are used most frequently for PDA closure worldwide, with a high occlusion rate and few complications. Transcatheter PDA closure in preterm or low-bodyweight infants remains a highly challenging procedure and further device and catheter design development is indicated before transcatheter closure is the treatment of choice in this delicate patient population. The evolution of transcatheter PDA closure from just 40 years ago with 18F sheaths to device delivery via a 3F sheath is remarkable and it is anticipated that further improvements will result in better safety and efficacy of transcatheter PDA closure techniques.
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Affiliation(s)
- Alban-Elouen Baruteau
- M3C Marie-Lannelongue Hospital, Paediatric and Congenital Cardiac Surgery, Paris Sud University, Paris, France; Inserm UMR 1087, CNRS UMR 6291, l'Institut du Thorax, Nantes University, Nantes, France.
| | - Sébastien Hascoët
- M3C CHU Toulouse, Children's Hospital, Paediatric Cardiology, Paul-Sabatier University, Toulouse, France
| | - Julien Baruteau
- Great Ormond Street Hospital for Children, Metabolic Medicine Department, University College London, Institute for Women's Health, Gene Therapy Transfer Group, London, UK
| | - Younes Boudjemline
- M3C Necker Hospital for Sick Children, Paediatric Cardiology, Paris Descartes University, Paris, France; M3C Georges-Pompidou European Hospital, Adult Congenital Cardiology, Paris, France
| | - Virginie Lambert
- M3C Marie-Lannelongue Hospital, Paediatric and Congenital Cardiac Surgery, Paris Sud University, Paris, France; Inserm UMR 999, Marie-Lannelongue Hospital, Paris, France
| | - Claude-Yves Angel
- M3C Marie-Lannelongue Hospital, Paediatric and Congenital Cardiac Surgery, Paris Sud University, Paris, France
| | - Emre Belli
- M3C Marie-Lannelongue Hospital, Paediatric and Congenital Cardiac Surgery, Paris Sud University, Paris, France
| | - Jérôme Petit
- M3C Marie-Lannelongue Hospital, Paediatric and Congenital Cardiac Surgery, Paris Sud University, Paris, France
| | - Robert Pass
- Children's Hospital at Montefiore, Pediatric Cardiology, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY, USA
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Pepeta L. Ductal closure using the Amplatzer duct occluder type two: experience in Port Elizabeth hospital complex, South Africa: cardiovascular topic. Cardiovasc J Afr 2013; 24:202-7. [PMID: 23812377 PMCID: PMC4986386 DOI: 10.5830/cvja-2013-033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2012] [Accepted: 05/10/2013] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE To report outcomes in percutaneous ductal closure using the Amplatzer duct occluder type two (ADO II). METHODS Records of patients admitted for percutaneous closure of patent ductus arteriosus (PDA) were reviewed. RESULTS From May 2009 to July 2012, 36 patients were assigned to closure using the ADO II. There were 21 females and 15 males. The median age was 16.5 (2-233) months; median weight, 8 (3.94-39.2) kg; and median height, 75 (55-166) cm. The mean pulmonary artery pressure was 24.4 (± 10.4) mmHg, the pulmonary blood flow:systemic blood flow (Qp:Qs) ratio was 2.25 (± 1.97), and mean pulmonary resistance (Rp) was 1.87 (± 1.28) Wood units. The mean ductal size was 2.74 (± 1.3) mm. In 30 patients the device was delivered through the pulmonary artery. Thirty-three patients achieved complete closure by discharge (day one). CONCLUSION The ADO II is capable of closing a wide range of ducts in carefully selected patients. Our findings are comparable with other studies regarding ductal closure rates.
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Affiliation(s)
- Lungile Pepeta
- Division of Paediatric Cardiology, Paediatrics and Child Health, Dora Nginza Hospital, Port Elizabeth, Eastern Cape South Africa
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14
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Sungur M, Karakurt C, Ozbarlas N, Baspinar O. Closure of patent ductus arteriosus in children, small infants, and premature babies with Amplatzer duct occluder II additional sizes: Multicenter study. Catheter Cardiovasc Interv 2013; 82:245-52. [DOI: 10.1002/ccd.24905] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2012] [Revised: 02/19/2013] [Accepted: 02/26/2013] [Indexed: 11/09/2022]
Affiliation(s)
- Metin Sungur
- Department of Pediatric Cardiology; Ondokuz Mayis University; Samsun Turkey
| | - Cemsit Karakurt
- Department of Pediatric Cardiology; İnönü University; Malatya Turkey
| | - Nazan Ozbarlas
- Department of Pediatric Cardiology; Cukurova University; Adana Turkey
| | - Osman Baspinar
- Department of Pediatric Cardiology; Gaziantep University; Gaziantep Turkey
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15
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Liddy S, Oslizlok P, Walsh KP. Comparison of the results of transcatheter closure of patent ductus arteriosus with newer amplatzer devices. Catheter Cardiovasc Interv 2013; 82:253-9. [DOI: 10.1002/ccd.24768] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2012] [Revised: 11/13/2012] [Accepted: 11/25/2012] [Indexed: 11/10/2022]
Affiliation(s)
- Stephen Liddy
- Department of Cardiology; St Vincent's University Hospital; Dublin 4 Ireland
| | - Paul Oslizlok
- Cardiac Department; Our Lady's Hospital for Sick Children; Crumlin Dublin Ireland
| | - Kevin P. Walsh
- Cardiac Department; Our Lady's Hospital for Sick Children; Crumlin Dublin Ireland
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16
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Latson L. Kinder, gentler PDA devices. Catheter Cardiovasc Interv 2012; 79:1175. [DOI: 10.1002/ccd.24453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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