BACKGROUND: A new generation of Amplatzer devices with lower profile and greater flexibility has been recently developed for percutaneous occlusion of the patent ductus arteriosus (PDA). In this paper, the use of this new device, the Amplatzer Duct Occludder II TM (ADO II) for percutaneous closure of the PDA as well as for the treatment of other congenital and structural heart defects is reported, assessing its safety and efficacy. METHODS: Longitudinal and observational study of a cohort of patients with congenital and structural heart defects treated with ADO II between October 2009 and August 2011. Patients weighing less than 5 kg and PDAs > 5.5 mm and/or type B were excluded. The device was implanted using the antegrade or retrograde approach. The waist was 2 mm larger than the defect and the length of the prosthesis was 4 mm for shorter lesions (less than 6-8 mm). RESULTS: Twenty-eight patients with a median age and weight of 2 years and 11.7 kg, respectively, were included. Twenty-three had a PDA with a mean minimal diameter of 2.3 + 0.8 mm. The remainder had muscular ventricular septal defect (1), pulmonary arteriovenous fistula (1), ruptured aneurysm of the sinus of Valsalva (1), and univentricular heart in the early postoperative period of bidirectional cavopulmonary anastomosis with residual antegrade pulmonary flow (2). The device was successfully implanted in all patients, except for an infant weighing 8 kg with a long, tortuous and oblique PDA with a diameter of 2.8 mm and a shallow ampulla. There was total occlusion of the defects in all patients. One patient with univentricular heart and right isomerism died due to complications not related to the procedure. CONCLUSIONS: ADO II proved to be a flexible, safe and effective device for the percutaneous treatment of infants, children and selected adults with PDA and other congenital and structural heart defects. Its use may have limitations for some anatomical PDA configurations in smaller infants.
Heart defects; congenital; Ductus arteriosus; Heart catheterization; Prostheses and implants
