Estudio de la perfusión pulmonar posterior al cierre percutáneo del conducto arterioso permeable utilizando el dispositivo Amplatzer Duct Occluder en niños

Abstract

The left lung perfusion may be compromised after percutaneous closure of patent ductus arteriosus with the Amplatzer Duct Occluder. The increased flow velocity in the origin of the left pulmonary artery can be a poor indicator of reduction in pulmonary perfusion and can occur in the absence of protrusion of the device.

Left Pulmonary Artery Stenting for Left Pulmonary Artery Stenosis Following Patent Ductus Arteriosus Device Closure: Case Series and Review of the Literature

“…However, even if the presence of device protrusion into the MPA does not predict an LPA obstruction, it is logical to think that it is a prerequisite to developing this complication. An abnormal postdevice placement left lung perfusion has been described in 16%–37% of cases with different devices [ 11 – 15 ]. All of these reports consider left lung perfusion below 40% as abnormal [ 11 – 15 ].…”

“…An abnormal postdevice placement left lung perfusion has been described in 16%–37% of cases with different devices [ 11 – 15 ]. All of these reports consider left lung perfusion below 40% as abnormal [ 11 – 15 ]. The timing of the perfusion study could be relevant since an obstruction might not be initially present but may develop progressively, as described in premature born babies [ 16 ].…”

“…Some risk factors for post-PDA device LPA stenosis have been identified: young age [ 11 – 14 ], low weight [ 11 , 13 , 14 ], larger PDA size for body surface area [ 14 ], and ductal length [ 11 , 13 ]. There is a growing body of evidence in neonates and specifically in premature babies ever since the Piccolo device (Abbott Structural Heart, Plymouth, MN, USA) was formally introduced to the market, suggesting that small infants and particularly preterm babies are at higher risk of LPA obstruction following device placement.…”