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Case Reports
. 2012 Jul;5(2):210-2.
doi: 10.4103/0974-2069.99632.

Transcatheter interruption of large residual flow after device closure of "Type A" patent ductus arteriosus

Anuradha Sridhar  1 , Raghavan Subramanyan, Premsekar Rajasekar
Affiliations
Case Reports

Transcatheter interruption of large residual flow after device closure of "Type A" patent ductus arteriosus

Anuradha Sridhar et al. Ann Pediatr Cardiol. 2012 Jul.

Abstract

We report a case of 3-year-old girl who had persistence of large residual flow following transcatheter closure of a 6 mm 'Type A' patent ductus arteriosus using a 12 × 10 mm duct occluder. Angiography revealed a large left-to-right shunt coursing through and exiting around the implanted device. Near total abolition of the residual shunt was achieved by initial implantation of an embolization coil within the duct occluder and subsequently an Amplatzer duct occluder (ADO II) adjacent to the duct occluder. This challenging case describes an additional technique of abolishing a large residual flow in and around a Nitinol duct occluder device.

Keywords: Ductus arteriosus; endothelialization; residual shunt; transcatheter closure.

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Conflict of interest statement

Conflict of Interest: None declared

Figures

Figure 1
Figure 1
(a) Aortogram after the release of the Cocoon duct occluder showing good position of device with moderate diffuse residual shunt through the device (arrow); PA: pulmonary artery, AO: aorta. (b) Endothelialization seen as a 1-2 mm thick white line (arrows) along the body of the device indicating that the device is secure
Figure 2
Figure 2
(a) Aortogram after intra-device coil embolization showing coil in good position (arrow) inside the device with no significant reduction in shunt. (b) Terumo wire passed through the device into the pulmonary artery showing the space around the pulmonary end of the Cocoon duct occluder
Figure 3
Figure 3
(a) ADO II (small arrows) placed adjacent to the previously implanted Cocoon duct occluder. (b) Aortogram after deployment of the ADO II showing good position of both devices and the coil inside the device. There was a marginal reduction in the shunt through the device. (c) Echocardiography before discharge showing significant reduction in the shunt flow to a restrictive low velocity shunt
See this image and copyright information in PMC

References

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