Transcatheter closure of large sized patent ducts arteriosus using the amplatzer duct occluder device

To assess the results of anterograde transcatheter closure of a large sized patent ductus arteriosus using the Amplatzer Duct Occluder [ADO] device. A case series. Department of Cardiology, Armed Forces Institute of Cardiology and National Institute of Heart Diseases, Rawalpindi, from January 2005 to December 2007. All patients who underwent transcatheter closure of large sized PDA [4.0 mm], using the Amplatzer Duct Occluder [ADO] device, from January 2005 to December 2007, were included by convenient sampling technique. After the procedure, repeat aortogram was performed to confirm the appropriate position of the ADO and to evaluate for residual shunts. A total of 100 patients had PDA diameter of 4.00 mm. Mean age was 11.73 +/- 10.31 years and there were 37 males and 63 females. Mean PDA diameter was 6.011 +/- 2.078 mm. Forty-nine patients had type 'A', 19 had type 'B', 19 patients had type 'C', 5 had type 'D' and 8 patients had type 'E' PDA. Complete closure was achieved in 70 patients, 26 had trace shunt and 4 patients had small residual shunt immediately after the procedure. However, no patient had residual shunt 24 hours after the procedure. ADO is a highly efficient prosthesis that can be safely applied in most patients with PDA particularly in patients with large sized PDA

Profile of congenital heart disease and correlation to risk adjustment for surgery; an echocardiographic study

To determine the pattern and profile of Congenital Heart Diseases [CHD] in paediatric patients [age 1 day to 18 years] presenting to a paediatric tertiary referral centre and its correlation to risk adjustment for surgery for congenital heart disease. Descriptive case series. Paediatric Cardiology Department, Armed Forces Institute of Cardiology/National Institute of Heart Diseases, Rawalpindi [AFIC/NIHD]. Over a period of 6 months, 1149 cases underwent 2-D echocardiography. It was a non-probability purposive sampling. This study showed 25% of all referrals had normal hearts. A male preponderance [38%] was observed from 1 year to 5 years age group. Nineteen percent of the cases were categorized as cyanotic CHD with the remaining as acyanotic variety. Tetralogy of Fallot [TOF] represented 10%, Ventricular Septal Defects [VSD] 24%, followed by Patent Ductus Arteriosus [PDA] and Atrial Septal Defect [ASD], which comprised 6.6% and 6.5% respectively. VSD was the most common association in patients with more complex CHD [10%] followed by PDA in 3% and ASD in 1.2% of the cases. Most of the cases were category 2 in the RACHS-1 scoring system. VSD and TOF formed the major groups of cases profiled. Most of the cases recommended for surgery for congenital heart disease belonged to the risk category 2 [28.1%] followed by the risk category 1 [12.7%] of the RACHS-1 scoring system