Transcatheter closure of patent ductus arteriosus in adults using the Amplatzer duct occluder: initial results and follow-up.

BACKGROUND: Surgical closure of patent ductus arteriosus in adult patients may be problematic. Transcatheter closure of patent ductus arteriosus is an established procedure. Recently, transcatheter closure of patent ductus arteriosus using the Amplatzer duct occluder has been shown to be safe and efficacious. We present our experience with this device in adults. METHODS AND RESULTS: Between January 2000 and January 2002,41 adult patients (31 females and 10 males) with a patent ductus arteriosus were referred for closure with the Amplatzer duct occluder. The median age was 35.6 years (range 18-70.7 years) and the median weight was 65.8 kg (range 32.7-164.5 kg). Of these 41 patients, 37 underwent attempted closure of the patent ductus arteriosus using the Amplatzer duct occluder. The device was successfully deployed in all patients except 1. Complete angiographic closure was seen Immediately after device deployment in 29 out of 36 patients (81%). Complete echocardiographic closure was demonstrated within 24 hours post-procedure in 34 out of 36 patients (94%), and at 6-month follow-up in 35 out of 36 patients (97%). No complications related to device implantation occurred in any patient. CONCLUSIONS: Closure of patent ductus arteriosus using the Amplatzer duct occluder is safe and effective in adults.

Experiência inicial no fechamento percutâneo da comunicaçäo interatrial com a prótese de amplatzer / Initial experience in percutaneous occlusion of atrial septal defects with the amplatzer device

OBJETIVO: Analisar a experiência inicial no fechamento percutâneo da comunicaçäo interatrial ostium secundum (CIA OS) com a prótese de amplatzer. MÉTODOS: Sete pacientes foram submetidos ao procedimento através da via venosa anterógrada,orientados pela ecocardiografia transesofágica (ETE) e sob anestesia geral. Uma criança era portadora de 2 CIA e de canal arterial (CA). As CIA medidas pelo ETE variaram de 8,7 a 20mm. Um ecocardiograma transtorácico foi realizado na manhä seguinte do procedimento. RESULTADOS: Oito prótese foram implantados nos 7 pacientes com sucesso. Em um paciente, o CA foi ocluído na mesma sessäo com mola de Gianturco, tendo surgido taquicardia supraventricular durante a oclusäo de uma das CIA, controlada com adenosina. Todos receberam alta hospitalar na manhä seguinte, com oclusäo total dos defeitos. CONCLUSÄO: O procedimento mostrou-se seguro, eficaz e versátil, podendo ser considerado como uma alternativa terapêutica inicial em pacientes selecionados com CIA OS.