Transcatheter Closure of Patent Ductus Arteriosus in Adults

Figures

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  Fig. 1. Important considerations in procedural planning for transcatheter closure of Patent Ductus Arteriosus (PDA) in adults – Morphologic factors, Complications, Co-morbidities and Device choice. ADOII – Amplatzer Duct Occluder II, AVPII – Amplatzer Vascular Plug II, AV loop – arteriovenous loop. Red checkmarks indicate advantage and red crosses indicate disadvantage of using the device

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  Fig. 2. Kirchenko classification of PDA morphologies. Type A: Conical shape with prominent aortic ampulla and constriction at pulmonary artery end, Type B: Short and wide (window type), Type C: Long tubular ductus without constriction, Type D: With multiple constriction (complex type), Type E: Elongated ductus with a constriction remote from the anterior edge of the trachea

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  Fig. 3. Examples of commonly used occluders for PDA closure. A) Amplatzer Duct Occluder; B) Occlutech PDA Occluder; C) Amplatzer Duct Occluder II; D) Amplatzer Muscular VSD Occluder; E) KONAR-MF VSD Occluder; F) Amplatzer Vascular Plug II

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  Fig. 4. An illustrative case of partial closure of PDA in the registry. A) Aortic (Ao) angiogram demonstrating large PDA filling the pulmonary artery (PA); B) Complete occlusion of the PDA using 18 × 30 mm Balloon; C) Puncturing the 18 mm post infarct muscular VSD occluder and advancing a Judkins Right guide catheter through it; D) Advancing the device guide wire assembly through a 14 F sheath and deployment of disc in aorta; E) Deployment of device; F) 4.5 × 22 mm coronary stent through the guide catheter; G) Complete stent deployment; H) En-face view of the device with a stent acting as fenestration