Immediate and early results of closure of moderate to large patent arterial ducts using the new Amplatzer (TM) device

Objectives. Our aim was to assess the immediate and short term results of c losure of moderate and large patent arterial ducts using the self-expanding and repositionable Amplatzer device. Method: We attempted closure in 25 pa tients (10 Females and 15 males) using the Amplatzer occluder. Their median age was 48 months with a range from 8months to 26years and median weight o f 14kg with a range from 4.5kg to 48kg. The mean ductal diameter was 4.1mm (S.D 1.51mm). A 6F/7F long sheath was used to deliver the device. Follow up was performed with colour-flow mapping of the pulmonary trunk within 24 ho urs, at 3 months, and 6 months of closure. Results: Of the 25 patients, the device was placed successfully in 23. Concurrent angiography showed immedi ate closure in 12 patients, while 8 had trivial shunting and 3 had mild shu nting. Within 24 hours, Doppler examination revealed complete closure in al l but three patients, who had a mild residual shunt. Two attempts were unsu ccessful. Both these patients underwent successful surgical ligation. All e xcept one patient were discharged on the next day. Of the 23 patients, 15 ( 65%) have been followed up for 3months, while 8 (35%) have completed 6 mont hs of follow-up. Of the three patients initially with mild residual flow, t wo had completely closed at 3 months The one remaining patient is yet to be seen at the 3 month follow-up. Thus, at 3 months, all patients studies had shown complete closure. Conclusion. Antegrade transcatheter closure using the Amplatzer duct occluder is an efficacious treatment for bigger patent a rterial ducts. Long-term follow-up is necessary to show sustained benefits and confirm the absence of side effects.