Next Article in Journal
Rauchen und Kardiovaskuläre Erkrankungen
Previous Article in Journal
Kammertachykardie aus Substrat
 
 
Cardiovascular Medicine is published by MDPI from Volume 28 Issue 1 (2025). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Editores Medicorum Helveticorum (EMH).
Font Type:
Arial Georgia Verdana
Font Size:
Aa Aa Aa
Line Spacing:
Column Width:
Background:
Case Report

New Amplatzer Duct Occluder II for Antegrade Closure of Patent Ductus Arteriosus

by
Stéphane Cook
1,2,
Tobias Rutz
1,2 and
Bernhard Meier
1,2,*
1
Cardiology, University Hospital, CH-3010 Bern, Switzerland
2
Hôpital Cantonal, Fribourg, Switzerland
*
Author to whom correspondence should be addressed.
Cardiovasc. Med. 2009, 12(11), 313; https://doi.org/10.4414/cvm.2009.01457
Submission received: 13 August 2009 / Revised: 13 September 2009 / Accepted: 13 October 2009 / Published: 13 November 2009

Summary

Transcatheter closure of patent ductus arteriosus is a safe and effective technique. The new version of the Amplatzer PDAoccluder (Amplatzer Duct Occluder II) permits antegrade delivery and significantly simplifies the procedure.

Introduction

Patent ductus arteriosus (PDA) was one of the first congenital cardiovascular lesions to be treated by nonsurgical catheter intervention. Since the first publication by Porstmann in 1967, nonsurgical transcatheter closure has gained widespread acceptance. Various devices have been used, including Rashkind PDA occluder, Gianturco coils, detachable coils, CardioSEAL, Sideris occluder and other umbrella devices. Since its first implantation in humans in 1998, the Amplatzer PDA occluder (AGA Medical Corporation, MN, USA) [1,2] has rapidly superseded the previously popular Rashkind PDAoccluder. In contrast to coils, it can also be used in large PDAs [3,4]. The Amplatzer PDA occluder is a self-expanding device made from 144 Nitinol wires in the form of a round mesh with a central waist and two discs on either side. With the original version of the occluder occlusion was achieved via the retrograde, venous access approach. The new version of the device (Amplatzer Duct Occluder II,AGAMedical Corporation, MN, USA) has been improved to permit antegrade arterial access delivery.

Case Report

A 28-year-old female patient presented for investigation of a continuous heart murmur. Echocardiography revealed a left-to-right shunt through a patent ductus arteriosus (Figure 1a) and the patient was referred for outpatient percutaneous closure.
Aortography confirmed the echocardiographic findings (Figure 1a). The 0.035’’ wire crossed the ductus arteriosus easily. Then the 4 French (F) pigtail catheter was exchanged for the 4 F delivery sheath to allow implantation of a 44-mm Amplatzer Duct Occluder II (AGA Medical Corporation, MN, USA). Fluoroscopy time was 5 min. The shunt was completely eliminated, as documented by angiography immediately after device closure (Figure 2) and by echocardiographic follow-up evaluation the same day. The patient was discharged a few hours after the intervention.

Conclusion

Transcatheter closure of patent ductus arteriosus by the Amplatzer Duct Occluder is an easy, safe and effective technique. The new antegrade (arterial) delivery option of the Duct Occluder II simplifies the procedure significantly.

References

  1. Masura, J.; Walsh, K.P.; Thanopoulous, B.; Chan, C.; Bass, J.; et al. Catheter closure of moderate- to large-sized patent ductus arteriosus using the new Amplatzer duct occluder: immediate and short-term results. J Am Coll Cardiol. 1998, 31, 878–882. [Google Scholar] [CrossRef] [PubMed]
  2. Sharafuddin, M.J.; Gu, X.; Titus, J.L.; Sakinis, A.K.; Pozza, C.H.; Coleman, C.C.; et al. Experimental evaluation of a new self-expanding patent ductus arteriosus occluder in a canine model. J Vasc Interv Radiol. 1996, 7, 877–887. [Google Scholar] [CrossRef] [PubMed]
  3. O’Donnell, C.; Neutze, J.M.; Skinner, J.R.; Wilson, N.J. Transcatheter patent ductus arteriosus occlusion: evolution of techniques and results from the 1990s. J Paediatr Child Health. 2001, 37, 451–455. [Google Scholar] [CrossRef] [PubMed]
  4. Chatterjee, T.; Windecker, S.; Pfammatter, J.P.; Seiler, C.; Meier, B. Non-surgical closure of patent ductus arteriosus: acute and long-term results. Schweiz Med Wochenschr. 2000, 130, 664–670. [Google Scholar] [PubMed]
Figure 1. a) Parasternal short axis echocardiographic view of the aortic valve showing the right ventricular outflow tract and the pulmonary main artery (PA). Colour flow imaging of systolic left-to-right shunt (red) through the patent ductus arteriosus (PDA), and b) subsequent confirmation of diagnosis by aortography (4 French pigtail catheter in descending aorta, Ao).
Figure 1. a) Parasternal short axis echocardiographic view of the aortic valve showing the right ventricular outflow tract and the pulmonary main artery (PA). Colour flow imaging of systolic left-to-right shunt (red) through the patent ductus arteriosus (PDA), and b) subsequent confirmation of diagnosis by aortography (4 French pigtail catheter in descending aorta, Ao).
Cardiovascmed 12 00313 g001
Figure 2. a to f: Sequential percutaneous closure of the PDA by delivery of a 4 4-mm Amplatzer Duct Occluder II.
Figure 2. a to f: Sequential percutaneous closure of the PDA by delivery of a 4 4-mm Amplatzer Duct Occluder II.
Cardiovascmed 12 00313 g002

Share and Cite

MDPI and ACS Style

Cook, S.; Rutz, T.; Meier, B. New Amplatzer Duct Occluder II for Antegrade Closure of Patent Ductus Arteriosus. Cardiovasc. Med. 2009, 12, 313. https://doi.org/10.4414/cvm.2009.01457

AMA Style

Cook S, Rutz T, Meier B. New Amplatzer Duct Occluder II for Antegrade Closure of Patent Ductus Arteriosus. Cardiovascular Medicine. 2009; 12(11):313. https://doi.org/10.4414/cvm.2009.01457

Chicago/Turabian Style

Cook, Stéphane, Tobias Rutz, and Bernhard Meier. 2009. "New Amplatzer Duct Occluder II for Antegrade Closure of Patent Ductus Arteriosus" Cardiovascular Medicine 12, no. 11: 313. https://doi.org/10.4414/cvm.2009.01457

APA Style

Cook, S., Rutz, T., & Meier, B. (2009). New Amplatzer Duct Occluder II for Antegrade Closure of Patent Ductus Arteriosus. Cardiovascular Medicine, 12(11), 313. https://doi.org/10.4414/cvm.2009.01457

Article Metrics

Back to TopTop