Transcatheter closure of large sized patent ductus arteriosus using the amplatzer duct occluder device.

OBJECTIVE To assess the results of anterograde transcatheter closure of a large sized patent ductus arteriosus using the Amplatzer Duct Occluder (ADO) device. STUDY DESIGN A case series. PLACE AND DURATION OF STUDY Department of Cardiology, Armed Forces Institute of Cardiology and National Institute of Heart Diseases, Rawalpindi, from January 2005 to December 2007. METHODOLOGY All patients who underwent transcatheter closure of large sized PDA (> or = 4.0 mm), using the Amplatzer Duct Occluder (ADO) device, from January 2005 to December 2007, were included by convenient sampling technique. After the procedure, repeat aortogram was performed to confirm the appropriate position of the ADO and to evaluate for residual shunts. RESULTS A total of 100 patients had PDA diameter of > or = 4.00 mm. Mean age was 11.73 + 10.31 years and there were 37 males and 63 females. Mean PDA diameter was 6.011 + 2.078 mm. Forty-nine patients had type 'A', 19 had type 'B', 19 patients had type 'C', 5 had type 'D' and 8 patients had type 'E' PDA. Complete closure was achieved in 70 patients, 26 had trace shunt and 4 patients had small residual shunt immediately after the procedure. However, no patient had residual shunt 24 hours after the procedure. CONCLUSION ADO is a highly efficient prosthesis that can be safely applied in most patients with PDA particularly in patients with large sized PDA.