Long-term Results of Transcatheter Closure of Patent Ductus Arteriosus in Adolescents and Adults with Amplatzer Duct Occluder

BACKGROUND: Transcatheter closure of patent ductus arteriosus (PDA) with the Amplatzer ductal occluder (ADO) has become a standard procedure in most pediatric patients. However, experience in adults and adolescents is limited. Our experience of transcatheter closure of PDA with ADO in adolescents and adults is presented in this study. AIMS: The aim of this study was to investigate long-term outcomes of transcatheter closure of PDA in adolescents and adults with ADO. MATERIALS AND METHODS: In this study, 69 patients (52 females and 17 males) with PDA underwent transcatheter closure between May 2004 and October 2012. The procedure was performed under fluoroscopic guidance. Chest radiograph, electrocardiogram, transthoracic echocardiography (TTE), and clinical assessment of the patients were conducted before the procedure. Clinical and echocardiographic follow-ups were performed on day 1 of the 1st month, 6(th) month, and 12(th) month and then yearly after the procedure. RESULTS: The mean and standard deviation age of the patients was 18.08 ± 7.25 years (ranging 10-38 years). The mean and standard deviation angiographic diameter of PDA was 7.78 ± 2.78 mm. The mean and standard deviation size of the implanted device was 9.3 ± 2.9. The mean and standard deviation average pulmonary artery pressure was 32.1 ± 14.2 mmHg. The mean pulmonary flow/systemic flow ratio was 2.2 ± 0.61. The devices were successfully implanted in all patients (100%). Immediately after device implantation, 47 patients had residual shunts. The residual shunts disappeared in all the patients, except for one that lingered until 24 h after the procedure. No severe complication occurred at the immediate and long-term follow-ups. CONCLUSIONS: The long-term results suggested that transcatheter closure of PDA with ADO is a safe and effective treatment for adolescents and adults with PDA. Low complication rates and short hospital stays make this procedure the treatment of choice in most cardiovascular centers worldwide.