Further experience with transcatheter closure of the patent ductus arteriosus using the Amplatzer duct occluder
Basil (Vasilios) D. Thanopoulos, MD*,
Fakhri A. Hakim, MD ,
Aktham Hiari, MD,
Yousef Goussous, MD,
Evangelia Basta, MD*,
Armine A. Zarayelyan, MD* and
George S. Tsaousis, MD*
* Department of Pediatric Cardiology, "Aghia Sophia" Children’s Hospital, Athens, Greece
Department of Pediatric Cardiology, "Queen Alia" Heart Institute, Amman, Jordan
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Figure 1 Close-up view of the currently available ADO made of 0.004-in. Nitinol wire mesh. The arrow indicates the 2-mm retention disc that assures secure position in the mount of the PDA.
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Figure 2 Steps of transcatheter closure technique using the ADO in a 4-month-old, 4.2-kg infant (patient 31) with a large tubular PDA. A, Descending aortogram in the lateral projection demonstrating a large type C PDA measuring 5.2 mm in diameter. B, Deployment of the retention disc (arrowhead) of a 6-mm ADO against the orifice of the ductus results in severe aortic obstruction. C, Repeat descending aortogram after deployment of the ADO inside the PDA showing good position with no obstruction to the aorta and foaming through the device. D, Descending aortogram 15 min after release of the device, revealing complete closure with good device position.
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Figure 3 Descending aortogram in the lateral projection obtained from a patient (patient 36) with a large type E PDA, measuring 5 mm in diameter before (A) and after (B) implantation of an 8-mm ADO. Complete closure of the PDA has been achieved.
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