Percutaneous Occlusion of Patent Ductus Arteriosus with the Amplatzer® Vascular Plug II Device: Early Experience in Three Reference Centres

ABSTRACTBackgroundThe conventional devices available for the percutaneous occlusion of a patent ductus arteriosus (PDA) may have limitations, especially in small children and adults with a large ductus arteriosus. The Amplatzer® Vascular Plug II (AVP II) device has been used in these scenarios with promising results. This study aims to report an early experience with the AVP II device at three reference centres.MethodsThis was a prospective study with retrospectively collected data from patients who had undergone PDA occlusion with the AVP II since 2011. The devices were implanted using the anterograde approach under general anaesthesia, except for in one patient. Technical aspects, immediate occlusion, and complication rates were assessed.ResultsForty patients (67.5% females) with a median age of 56.7 months (6 months to 654.7 months) and a median weight of 17.3kg (5kg to 93kg) were included. Of these, 36 had a type A PDA, three had a type E PDA, and one had a type C PDA. The mean diameters of the ductus and of the device were 3.7±1.5mm and 9.4±3.6mm, respectively. In 3 patients, the initial device had to be replaced by another device of a different size. In one patient, an unsuccessful attempt led to the use of two implant devices. This patient was later referred for surgical repair. In five patients, a mild protrusion of the disc towards the aorta was observed, but the protrusion did not cause a significant pressure gradient. Residual flow was observed in two patients. There were no significant complications.ConclusionsThe AVP II device is a safe and effective alternative for PDA treatment, especially in patients with limitations to the conventional occlusion procedure