William M Wilson1, Ashish Shah2, Mark D Osten2, Lee N Benson2, Natalie Abraha2, Daniel Breitner2, Eric M Horlick3. 1. Royal Melbourne Hospital, Melbourne, Australia. 2. Toronto Congenital Cardiac Centre for Adults, Toronto General Hospital, Toronto, Canada. 3. Toronto Congenital Cardiac Centre for Adults, Toronto General Hospital, Toronto, Canada. Electronic address: eric.horlick@uhn.ca.
Abstract
BACKGROUND: There is little published data regarding percutaneous patent ductus arteriosus (PDA) closure in adults. We aim to describe the outcomes of adult patients undergoing PDA closure at a single tertiary referral centre. METHODS: All adults who underwent device PDA closure at our centre from 2001 to 2017 were identified and enrolled in the study. Available clinical data and imaging data were reviewed. RESULTS: At total of 141 patients were identified, with a mean age of 43 ± 15 years. Left ventricular dilation was present in 27% and pulmonary hypertension in 36% of the patients. Most ducts (74%) were of type A morphology. Mean ductal diameter at the pulmonary artery end was 4.1 ± 1.9 mm and mean length was 10.0 ± 4.7 mm. Wire passage from the pulmonary artery was achieved in 79%. Procedural success rate was 100%, and an Amplatzer duct occluder was deployed in all successful cases (ADO1 device in 97%). There was a small residual shunt in 6% at the time of closure, and only 2 patients had a residual leak on echocardiography at a median 3 months' follow-up. No major complications occurred. CONCLUSIONS: Transcatheter PDA closure with the use of an Amplatzer duct occluder is very effective in adults across all duct morphologies and associated with a very low complication rate.
BACKGROUND: There is little published data regarding percutaneous patent ductus arteriosus (PDA) closure in adults. We aim to describe the outcomes of adult patients undergoing PDA closure at a single tertiary referral centre. METHODS: All adults who underwent device PDA closure at our centre from 2001 to 2017 were identified and enrolled in the study. Available clinical data and imaging data were reviewed. RESULTS: At total of 141 patients were identified, with a mean age of 43 ± 15 years. Left ventricular dilation was present in 27% and pulmonary hypertension in 36% of the patients. Most ducts (74%) were of type A morphology. Mean ductal diameter at the pulmonary artery end was 4.1 ± 1.9 mm and mean length was 10.0 ± 4.7 mm. Wire passage from the pulmonary artery was achieved in 79%. Procedural success rate was 100%, and an Amplatzer duct occluder was deployed in all successful cases (ADO1 device in 97%). There was a small residual shunt in 6% at the time of closure, and only 2 patients had a residual leak on echocardiography at a median 3 months' follow-up. No major complications occurred. CONCLUSIONS: Transcatheter PDA closure with the use of an Amplatzer duct occluder is very effective in adults across all duct morphologies and associated with a very low complication rate.
Authors: Rachel Reo; Erin Van Pelt; Casey Lovelace; Anne Eshelman; Brian Beckman; Joanne Chisolm; Brian Boe; Carl Backes; Clifford L Cua Journal: Cardiol Ther Date: 2022-07-03