The Amplatzer duct occluder for PDA closure : indications, technique of implantation and clinical outcome

Abstract

Following its introduction into clinical practice, the Amplatzer duct occluder (ADO) has achieved a definite place in the armamentarium of the interventional cardiologist for the closure of moderate to large sized PDAs. The device combines ease of use, including retrievability and repositioning when required, and a high occlusion rate (>99% complete occlusion of PDA within 6 months of implant, with the majority of occlusions occurring within 24 hours of implant). Possible complications, such as device embolization, protrusion of the retention disc of the device into the aorta producing aortic obstruction, or obstruction of a branch pulmonary artery by the device are also uncommon and can be avoided by choosing the appropriate sized device (with the pulmonary end of the device being 2mm larger in diameter than the minimum measured ductal diameter), and paying scrupulous attention to technique of deployment. The device can be safely deployed in infants >3.5 kg, and can currently close PDAs of upto 11 to 12mm in minimum diameter. A brief description of the device, the technique of implantation, and the clinical results to date are provided.