Transarterial Ductal Occlusion Using the Amplatz® Canine Duct Occluder in 23 Cases
The Michael E. DeBakey Institute, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University
College Station, TX, USA
Transarterial ductal occlusion using the Amplatz® canine duct occluder (ACDO) was first reported by Nguyenba et al in 2007. Herein we report the results of Amplatz® canine duct occluder deployment in 23 dogs with PDA. The study population consisted of 17 females and 6 males, ranging in age from 2.5 to 102 months (median 5.6 months) and weighing between 2.3 and 37 kilograms (median 5.7 kg). Sixteen dogs had isolated, uncomplicated left-to-right shunting PDA. Concurrent congenital cardiac defects included mild pulmonic stenosis and subaortic stenosis in two dogs, mild pulmonic stenosis in two dogs, moderate subaortic stenosis in one dog mild subaortic stenosis in one dog and suspected mitral valve dysplasia in one dog.
PDA morphology was classified by angiography, followed by ductal occlusion with a single Amplatz® canine duct occluder. All dogs had a type II PDA, with 22 dogs having type IIA morphology and 1 dog having type IIB morphology. Angiographic ductal length was 17 ± 6.9 mm (mean ± 1 SD). The mean diameter of the ductal ampulla was 8.5 ± 3.7. Mean minimal ductal diameter was 3.1 ± 1.6 mm (range 1.2-5.9 mm). Mean ACDO diameter to angiographic minimal ductal diameter ratio was 1.8 ± 0.6. Median fluoroscopy time was 6.9 minutes (range 2.6-25.7 minutes). Appropriate device deployment was achieved in 22 of 23 dogs. Device deployment was not achieved in one dog due to the need for a larger device and inability to place an appropriately sized catheter. That dog's PDA was subsequently closed by surgical ligation. Angiography was performed and recorded 5-10 minutes following device deployment in 21 dogs documenting complete occlusion in 16 dogs and trivial flow in 5 dogs (not recorded in 1 dog). Based on transthoracic color Doppler echocardiography performed the day following the procedure, complete occlusion was achieved in all dogs. The only complication was femoral artery tearing in 2 dogs, with no significant bleeding and successful ligation at the completion of the procedure. We conclude that ductal occlusion using an Amplatz® canine duct occluder is a safe and efficacious therapy for PDA in dogs.