Transcatheter occlusion of the persistently patent ductus arteriosus. Forty-month follow-up and prevalence of residual shunting.

Hosking, Martin; Benson, Lee; Musewe, Norman N.; Dyck, John D.; Freedom, Robert M.

doi:10.1161/01.cir.84.6.2313

Cited by 195 publications

(88 citation statements)

References 15 publications

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“…12 In this study, the degree of left-to-right shunting before or after the procedure was not assessed. All patients at the time of discharge from the catheterisation laboratory had no shunt murmur suggesting a significant reduction (or complete elimination) of flow through the arterial duct.…”

Section: Discussionmentioning

confidence: 98%

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Closure of persistently patent arterial duct and its impact on cerebral circulatory haemodynamics in children

Bissonnette

Benson

1998

Can J Anaesth

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Closure of persistently patent arterial duct and its impact on cerebral circulatory haemodynamics in childrenPurpose: Closure of a patent arterial duct (PDA) is suggested as a risk factor associated with intraventricular haemorrhage and/or cerebral ischemia in neonates. This study evaluate the effects of transcatheter closure of a patent arterial duct in children on cerebral blood flow velocity. Methods: Twelve children, aged from one to eight years were enrolled. Anaesthesia induction consisted of thiopentone, fentanyl and diazepam. Tracheal intubation was facilitated with vecuronium. Anaesthesia was maintained with N20 70% in O 2 and a PaCO 2 between 35 to 40 mmHg. No cerebral vasoactive agents were used. Mean arterial pressure (MAP), central venous pressure (CVP), heart rate were continuously recorded. Systolic (Vs) and diastolic (Vd) cerebral blood flow velocity (CBFV) were recorded. Cerebral perfusion pressure (CPP) was calculated. The mean CBF~, the systolic-mean ratio and the cereb~l blood volume were estimated from the area under the velocity-time curve (AUC) before PDA closure, immediately after and for I0 rain following occlusion. Results: The mean (_+ SD) age and weight were 30 -+ 22 mo and 13 -+ 5 kg, respectively. Continuous recording during duct closure showed an abrupt increase in Vd (P < 0.05) whereas Vs remained constant. The AUC increased after closure and persisted for 10 min (P < 0.05). Conclusion: This study confirms that closure of a PDA leads to acute changes in intracerebraJ diastolic flow and volume. This observation gives weight to mechanisms involved in IVH in smaller infants after arterial surgical duct closure. The anaesthetic technique used for arterial duct closure in these procedure could influence these observations.

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Section: Discussionmentioning

confidence: 98%

“…n Percutaneous transcathether closure of the arterial duct is used widely and is a safe, effective alternative to surgical closure. 12,13 To investigate the impact of closure of a persistently patent arterial duct on CBFV, cerebral haemodynamics were assessed during transcatheter duct occlusion in childhood.…”

mentioning

confidence: 99%

Closure of persistently patent arterial duct and its impact on cerebral circulatory haemodynamics in children

Bissonnette

Benson

1998

Can J Anaesth

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“…However, the approach of a ductus arteriosus larger than 3-3.5mm with this method, in addition to the association with a greater rate of embolism, requires adaptations in the implantation technique, multiple devices, and the use of coils for controlled delivery or larger in size [6][7][8][9][10] . The Rashkind umbrella, better indicated for these situations 3 , was recently withdrawn from the market because of its significant degree of residual shunt 11 . After the publication of the results of convincing experimental studies 12 , the Amplatzer prosthesis for percutaneous occlusion of ductus arteriosus was introduced for clinical application with encouraging results 13,14 .…”

mentioning

confidence: 99%

Percutaneous closure of ductus arteriosus with the amplatzer prosthesis. The Brazilian experience

Simöes¹,

Pedra²,

Esteves³

et al. 2001

Arq. Bras. Cardiol.

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“…Subsequently, a number of devices and coils have been used for catheter closure of PDA with varying degrees of success [17][18][19][20][21][22][23][24][25]. The major drawbacks of these devices and coils are the high incidence of residual shunt, the sometimes complex delivery systems and their unsuitability for larger PDAs.…”

Section: Discussionmentioning

confidence: 99%

Amplatzer Device closure of Atrial Septal Defects and Patent Ductus Arteriosus: Initial Experience

Dugal

Jetley

Singh

et al. 2003

Medical Journal Armed Forces India

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Surgical closure of Atrial Septal Defects (ASD) and Patent Ductus Arteriosus (PDA) can be performed successfully with low mortality. However, the morbidity associated with general anaesthesia, thoracotomy, cardiopulmonary bypass, postoperative monitoring in the intensive care unit, several days of hospital stay and the requirement of blood products is considerable. The expense associated with this morbidity, operative scar and the psychologic trauma to the patient and parents are additional disadvantages of surgery. Hence, the closure of these defects by transcatheter methods with various devices has been evaluated worldwide. We report the initial experience at our centre with closure of secundum ASDs and large PDAs with the Amplatzer Septal Occluder and Amplatzer Duct Occluder.

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Transcatheter occlusion of the persistently patent ductus arteriosus. Forty-month follow-up and prevalence of residual shunting.

Cited by 195 publications

References 15 publications

Closure of persistently patent arterial duct and its impact on cerebral circulatory haemodynamics in children

Closure of persistently patent arterial duct and its impact on cerebral circulatory haemodynamics in children

Percutaneous closure of ductus arteriosus with the amplatzer prosthesis. The Brazilian experience

Amplatzer Device closure of Atrial Septal Defects and Patent Ductus Arteriosus: Initial Experience

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