Transcatheter Management of Patent Ductus Arteriosus

Shim, David; Beekman, Robert H.

doi:10.1007/s002469900248

Cited by 22 publications

(8 citation statements)

References 22 publications

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“…Since its outcome is satisfactory with low complications, this technique has been accepted in the treatment of congenital vascular diseases in the past decades. [12,[15][16][17] In 1992 Cambier et al [18] used coils in transcatheter embolization of PDA. Thereafter coils have been designed to make the occlusion technique simpler so as to decrease the rate of complications.…”

Section: Discussionmentioning

confidence: 99%

Interventional occlusion of congenital vascular malformations

et al. 2009

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Section: Discussionmentioning

confidence: 99%

Interventional occlusion of congenital vascular malformations

et al. 2009

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“…Suitability for closure with Gianturco coils depends not only on the minimum PDA diameter, but also on the size and configuration of the entire ductus, quantity of shunt flow, and relative sizes of the PDA and descending aorta [13][14][15][16]. Essentially, there must be sufficient space within the ductus to accommodate enough coil mass to occlude flow, without causing obstruction in the aorta or pulmonary artery, and the ductal geometry must be such that the coil or coils can achieve a stable position and not migrate.…”

Section: Currently Available Devices Gianturco Coilsmentioning

confidence: 99%

Interventional treatment of patent ductus arteriosus in 2004

Moore

Levi

Moore

et al. 2004

Cathet. Cardiovasc. Intervent.

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In 2004, the interventional treatment of patent ductus arteriosus (PDA) is definitive and curative. In current practice, coils are used for smaller PDA, and devices are employed for larger PDA. Developing technologies offer small improvements in control and results, but do not appear to promise major changes in practice. This review summarizes the current and emerging interventional technologies directed at PDA closures.

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“…Dagegen fand der 1979 von Rashkind entwickelte, zusammenfaltbare, mit Polyurethan bespannte Doppelschirm, der als 12-mm-Schirm durch eine 8-F-, als 17-mm-Schirm durch eine ll-F-Schleuse eingefª wird, breite Anwendung [104]. Verschiedene Studien mit annahernd 1 000 Patienten zeigten einen kompletten VerschluB unmittelbar nach Implantation in 24 bis 44%, nach einem Jahr in 80 bis 83% [2,118].…”

Section: Das System Ist Derzeit In Deutschland Nicht Verfªunclassified

Neue Therapiemöglichkeiten in der interventionellen Kardiologie

Schmaltz

Neudorf

Sack³

et al. 1999

Herz

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The advancements of cardiac surgery over the last decades led to larger numbers of patients with operated congenital heart diseases surviving into adulthood. In Germany it is estimated that over 120,000 adults have operated congenital heart diseases. Five to 7% of them will need yearly hospital admissions. Interventional procedures are additional tools used to treat these patients with various sequelae or residua (Table 1). In the following review we concentrate on 2 different interventional procedures: dilatation and stent implantations for treatment of stenosis and the different devices used for the closure of shunt lesions. For congenital valvular pulmonary stenosis, balloon dilatation is the therapy of choice regardless the age of the patient. Stent implantation for the treatment of peripheral pulmonary stenosis (e.g., after previous systemic pulmonary shunts) can decrease the need for redo surgery, which is accompanied with increased risk. Stent implantations proved also to be useful to treat stenoses after Mustard patch in patients with transposition of the great arteries, after Fontan procedures or dealing with the rare pulmonary venous stenosis. In contrast, dilatation of bioprosthesis and conduit stenosis are not promising. Balloon dilatation of valvular aortic stenosis is an accepted therapy in childhood up to adolescents. Table 2 compares a surgical series including many infants with critical aortic stenosis with a series of balloon dilatation in children and another one in adults regarding lethality, complications, and results. Table 3 illustrates the immediate and late results of balloon dilatation of aortic coarctation in 3 different studies. The high recurrence rate in infants made clinicians refrain from taking this age group for balloon dilatation. In children and adult patients, good results are reported (75% reduction of gradients). The complication rate is low (2.3 to 3.3%) and aneurysm formation rate seldom (1 to 7%). Stenosed aorto-pulmonary collaterals will rarely need balloon dilatation. Surgical closure of atrial septal defect is a low risk procedure with a very low rate of residual shunts (2%). Of the 5 available devices for transcatheter closure of atrial septal defect Type II, only 2 occluders are in use in Germany, the Clamshell and the Amplatzer device. The largest clinical studies of the different systems, their efficacy, complications and residual shunt rate are presented in Table 4. For the deployment of these occluders a TEE is always needed. There are many more systems in clinical use to close the patent arterial duct (PDA) (Table 5). The Ivalon plug as well as the Rashkind device have probably only historical value. Different types of coils (Gianturco, Cook detachable, PFM) are now in use worldwide. The reason for their widespread use, besides their easy application, is the fact that most coils are relatively cheap and need only small sheaths for deployment. Their further evaluation identified a residual shunt rate of 5% as well as a number of complications (embolization, hemol...

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Transcatheter Management of Patent Ductus Arteriosus

Cited by 22 publications

References 22 publications

Interventional occlusion of congenital vascular malformations

Interventional occlusion of congenital vascular malformations

Interventional treatment of patent ductus arteriosus in 2004

Neue Therapiemöglichkeiten in der interventionellen Kardiologie

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