Long-term follow-up of patent ductus arteriosus closure with the Amplatzer Duct Occluder in children

ABSTRACT

Transcatheter closure of patent ductus arteriosus [PDA] has become an alternative treatment to surgery. We evaluated the long-term results of the transcatheter closure of PDA with the Amplatzer Duct Occluder [ADO] in children. Between May 2004 and October 2012, 138 children with PDA [43 males and 95 females] underwent transcatheter PDA closure. Clinical, electrocardiographic, echocardiographic, and hemodynamic data were assessed pre and postprocedurally and at follow-up. The mean age of the patients at procedure was 3.53 +/- 2.43 years [range = 1.1 to 9.5 years], mean weight was 11.9 +/- 4.6 kg [range = 6 to 29 kg], median pulmonary end diameter of the PDA was 5 mm [range = 4 to 15 mm], and median diameter of the ADO was 8 mm [range = 6 to 16 mm]. The mean follow-up time was 43.4 +/- 23.5 months [range = 13.5 to 98 months]. The devices were successfully deployed in 136 [98.5%] patients. Device embolization occurred in 2 patients, immediately in one patient and during the first postprocedural night in the other patient. The first patient had percutaneous device retrieval, followed by implantation of a larger device. The second patient had surgical device removal and PDA ligation. Immediately after device implantation, trivial to mild residual shunts were detected in 112 [80%] patients; all the shunts, however, disappeared 24 hours after the procedure. One patient had left pulmonary artery stenosis with a gradient of 25 mm Hg at 24 hours', 40 mmHg at one month's, and 64 mmHg at 6 months' follow-up. There were no cases of late embolization, aortic obstruction, late hemolysis, infective endocarditis, or death. Transcatheter PDA closure with the ADO was safe and effective, with a high success rate at long-term follow-up