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Extended applications of the Amplatzer vascular plug IV in infants

Published online by Cambridge University Press:  08 December 2010

Roland Adelmann
Affiliation:
Paediatric cardiology, Heart Center, University Hospital of Cologne, Cologne, Germany
Alfred Windfuhr
Affiliation:
Paediatric cardiology, Heart Center, University Hospital of Cologne, Cologne, Germany
Gerardus Bennink
Affiliation:
Paediatric cardiology, Heart Center, University Hospital of Cologne, Cologne, Germany
Mathias Emmel
Affiliation:
Paediatric cardiology, Heart Center, University Hospital of Cologne, Cologne, Germany
Narayanswami Sreeram*
Affiliation:
Paediatric cardiology, Heart Center, University Hospital of Cologne, Cologne, Germany
*
Correspondence to: Professor N. Sreeram, Paediatric cardiology, Heart Center, University Hospital of Cologne, Kerpenerstrasse 62, 50937 Cologne, Germany. Tel: +49 221 478 32330; Fax: +49 221 478 32515; E-mail: [email protected]

Abstract

Objective

A variety of devices are available for transcatheter closure of unwanted shunts. We describe our experience with the use of the Amplatzer vascular plug IV in a consecutive series of infants.

Methods

A total of eight consecutive infants – all born preterm at gestational ages ranging from 24 to 35 weeks – undergoing transcatheter closure of unwanted shunts – persistently patent arterial duct in five patients, an aorta to right atrium fistula in one, multiple aortopulmonary collateral vessels in one, and an azygos vein to left atrium connection in one – are described. Their age, from birth, ranged between 3 and 11 months, and weight between 2.6 and 11.3 kilograms. All devices were delivered using percutaneous arterial or venous vascular access via a large lumen (0.038 inch) 4-French delivery catheter.

Results

All lesions could be successfully occluded using one or more devices. Device diameters ranged between 4 and 8 millimetres, and exceeded the minimum diameter of the target vessel by 1 to 2 millimetres. Successful occlusion was confirmed either directly at angiography or on follow-up echocardiography. Of the infants who were mechanically ventilated prior to the procedure, three could be successfully weaned following closure of the shunt. There were no procedure-related complications.

Conclusions

The new vascular plug IV is cheap and efficacious in closing a variety of shunts in young infants, and warrants further extended clinical application.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2010

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