scholarly journals Transcatheter Closure of Patent Ductus Arteriosus in Elderly Patients: Initial and One-Year Follow-Up Results—Do We Have the Proper Device?

2020 ◽  
Vol 2020 ◽  
pp. 1-8 ◽  
Author(s):  
Michal Galeczka ◽  
Malgorzata Szkutnik ◽  
Jacek Bialkowski ◽  
Sebastian Smerdzinski ◽  
Mateusz Knop ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Patent Ductus Arteriosus ◽  
Transcatheter Closure ◽  
Nyha Class ◽  
Ductus Arteriosus ◽  
Wire Mesh ◽  
Residual Shunt ◽  
One Year ◽  
Patent Ductus

Objectives. Patent ductus arteriosus (PDA) in elderly patients is an uncommon anomaly, and the duct itself is often calcified and fragile; therefore, transcatheter closure is more difficult. The aim is to analyse periprocedural and one-year follow-up results of transcatheter closure of PDA in such patients. Methods and results. Retrospective analysis of 33 elective patients aged ≥55 years (median 63; 56–85; 29 women), in whom PDA was closed percutaneously between 2002 and 2018 in two tertiary centres. All but three patients were symptomatic, with most in NYHA II (n = 14) and III (n = 11) class; pulmonary hypertension (n = 22), arterial hypertension (n = 22), duct calcifications (n = 17), atrial fibrillation (n = 15), significant mitral regurgitation (n = 5), and decompensated renal failure (n = 2) were observed. Different devices were applied depending on PDA morphology; nitinol wire mesh occluders with symmetrical articulating discs have been the most used in recent years (n = 11). Follow-up was conducted at an outpatient clinic (28/33 patients). The procedure was successful in all patients. There was one embolisation, followed by implantation of a larger device. No major complications were noted. A small residual shunt was present in echocardiography in one patient after one year. NYHA class improved in all but two patients (with multiple comorbidities). Conclusions. Transcatheter PDA closure in elderly patients is safe and efficient with a high complete closure rate and few complications. Amplatzer duct occluder type II is an attractive device in such patients.

scholarly journals Transcatheter closure of patent ductus arteriosus using duct occluder: an eleven-year experience from a single tertiary cardiac center

2019 ◽  
Vol 7 (8) ◽  
pp. 2894
Author(s):  
Achyut Sarkar ◽  
Neha Rani ◽  
Prashant Kumar ◽  
Shyam Sundar Chaudhary ◽  
Suman Chatterjee
Keyword(s):  
Patent Ductus Arteriosus ◽  
Transcatheter Closure ◽  
Postgraduate Medical Education ◽  
Ductus Arteriosus ◽  
Volume Overload ◽  
Residual Shunt ◽  
Term Outcome ◽  
Procedural Success ◽  
Patent Ductus

Background: Patent Ductus Arteriosus (PDA) is a common congenital disorder. As an isolated lesion, PDA constitutes 6 to 11% of all congenital heart disease. PDA needs closure to eliminate pulmonary over circulation leading to volume overload of left ventricle, pulmonary vascular obstructed disease.Methods: This retrospective study was carried out in pediatric cardiology unit of Institute of Postgraduate Medical Education and Research, Kolkata from September 2005 to August 2016, which included 503 patients.Results: Device closure was attempted in 492 patient’s Procedural success was achieved in 85% cases on table, in who check aortogram revealed complete closure of PDA. In 15% cases, residual shunt was present. In 12% of cases, residual shunt disappeared during follow-up echocardiogram over 6-month follow-up. In 3% cases, small shunt remained at 6-month and 1-year follow up.Conclusion: Transcatheter closure of PDA by duct occluder is safe and effective with good mid-term outcome. The optimum assessment of ductul size and anatomy is crucial for optimum device size, which prevents residual shunt, device embolization and protrusion.

scholarly journals Hemolysis and its outcome following percutaneous closure of cardiac defects among children and adolescents: a prospective study

2019 ◽  
Vol 45 (1) ◽  
Author(s):  
Hamid Amoozgar ◽  
Romeileh Soltani ◽  
Mohammadreza Edraki ◽  
Nima Mehdizadegan ◽  
Hamid Mohammadi ◽  
...  
Keyword(s):  
Ventricular Septal Defect ◽  
Patent Ductus Arteriosus ◽  
Septal Defect ◽  
Transcatheter Closure ◽  
Ductus Arteriosus ◽  
Residual Flow ◽  
Intravascular Hemolysis ◽  
Device Closure ◽  
Residual Shunt ◽  
Patent Ductus

Abstract Background Transcatheter closure of intracardiac defects might be complicated by intravascular hemolysis. We evaluated hemolysis and its outcome after transcatheter closure of these defects. Methods and patients All patients who underwent transcatheter closure of patent ductus arteriosus, ventricular septal defect and atrial septal defect were included in this prospective study. Clinical data were obtained before and after the catheterization. Results One hundred and thirty-eight patients were enrolled; and four (3%) patients developed intravascular hemolysis; while two cases had residual shunt and two other cases had not residual flow. Although residual shunt occurred in ten patients, only 2 of these cases developed hemolysis. Patent ductus arteriosus closure was done for one of these cases and the other one, underwent perimembranous ventricular septal defect closure. Moreover, hemolysis occurred after device closure of patent ductus arteriosus in 2 of the other patients with no residual shunt. In this study the hemolysis was eliminated by conservative management within 2 weeks although residual shunt continued in this time. We observed a decline in lactate dehydrogenase value after catheterization in comparison with precatheterization, which was mainly among ventricular septal defect patients that might be due to mild chronic hemolysis in these patients. Conclusion Incidence of hemolysis after device closure was low, and occurred with and without residual flow and was eliminated by conservative management in 2 weeks, without the need for surgery, although the residual shunt was continued.

Long-term Follow-up Results of Lung Perfusion Studies after Transcatheter Closure of Patent Ductus Arteriosus

2012 ◽  
Vol 8 (2) ◽  
pp. 159-166 ◽  
Author(s):  
Fadli Demir ◽  
Ahmet Celebi ◽  
Turkay Saritas ◽  
Abdullah Erdem ◽  
Halil Demir ◽  
...  
Keyword(s):  
Patent Ductus Arteriosus ◽  
Transcatheter Closure ◽  
Ductus Arteriosus ◽  
Lung Perfusion ◽  
Perfusion Studies ◽  
Long Term Follow Up ◽  
Patent Ductus

scholarly journals Transcatheter closure of tubular type patent ductus arteriosus using Amplatzer® ductal occluder II: a case report

2016 ◽  
Vol 53 (5) ◽  
pp. 291
Author(s):  
Mulyadi M Djer ◽  
Nikmah Salamia Idris ◽  
Angelina Angelina
Keyword(s):  
Patent Ductus Arteriosus ◽  
Congenital Heart ◽  
Transcatheter Closure ◽  
Heart Diseases ◽  
Ductus Arteriosus ◽  
Preterm Neonates ◽  
Congenital Heart Diseases ◽  
Residual Shunt ◽  
Tubular Type ◽  
Patent Ductus

Patent ductus arteriosus (PDA) is a common congenital heart disease, accounting for 5-10% of all congenital heart diseases. The incidence of PDA is even higher in preterm neonates, ranging from 20-60%.1-4 Closure of PDA is indicated in all cases, except for duct-dependent congenital heart diseases or PDA with Eisenmenger syndrome.1,5,6 In small asymptomatic PDAs, closure is indicated to prevent the risk of complications, such as endarteritis, endocarditis, aneurysm of ductus arteriosus, or congestive heart failure.1,2,7In recent years, interventional cardiology has become a gold standard therapy for the majority of PDA cases beyond neonatal age. Since its introduction in 1967, many devices and methods have been developed to allow transcatheter closure of virtually all PDAs, regardless of size or configuration. Nevertheless, the tubular shape (type C) PDA, which has the highest residual shunt rate, still poses a great challenge for the interventionist.8-10 The second generation of Amplatzer® device occluders (ADO II), released in 2007, has been suggested to be effective in closing tubular PDAs.10 The purpose of this study was to report the initial clinical experience using ADO II to close a tubular type PDA in Indonesia.

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