Percutaneous occlusion of ductus arteriosus with Amplatzer™ Duct Occluder II AS

Abstract

Background Percutaneous occlusion of ductus arteriosus is well established as the method of choice to treat this structural heart defect. A new generation of Amplatzer™ Duct Occluder II Aditional Sizes prostheses, with lower profile and greater flexibility, in addition to smaller retention discs, was developed for percutaneous treatment of patent ductus arteriosus. This study intended to demonstrate the experience of one center with the use of this device, evaluating technical aspects, immediate occlusion rates, and complications. Methods A retrospective study of a cohort of patients with patent ductus arteriosus treated with Amplatzer™ Duct Occluder II Aditional Sizes. Between October 2018 and March 2021, 27 patients with patent ductus arteriosus, types A and E according to the Krichenko classification, were treated with Amplatzer™ Duct Occluder II Aditional Sizes. The prosthesis was implanted by the usual anterograde approach in 25 patients, and retrograde in two cases. The prosthesis chosen were 2mm larger than the core of the defect, and the length of the prosthesis was 2mm for shorter lesions and smaller infants, and between 4 and 6mm for longer lesions. Results Out of 27 patients, 52% were female, with a mean age and weight of 44.2 months (1 to 135 months) and 15.8kg (2,0 to 29kg), respectively. In the sample, 11 patients presented type A patent ductus arteriosus, and 16 type E, with a mean ratio of 1.9:1 between the prosthesis waist and the central diameter. In all patients, the device was successfully implanted, and only one patient remained with residual shunt, presenting embolization of the prosthesis. This patient had the ductus arteriosus closed by another prosthesis. Conclusion Amplatzer™ Duct Occluder II Aditional Sizes demonstrated safety, versatility, and efficiency in cases of appropriate anatomy. The experience demonstrated here is from a single center, with the Amplatzer™ Duct Occluder II Aditional Sizes. Its increased flexibility and softness demand greater operator expertise.