Article

The Amplatz (R) canine duct occluder: A novel device for patent ductus arteriosus occlusion (vol 9, pg 109, 2007)

Veterinary Clinical Sciences Department, College of Veterinary Medicine, University of Minnesota, St. Paul, MN 55108, USA.
Journal of veterinary cardiology: the official journal of the European Society of Veterinary Cardiology (Impact Factor: 1.32). 12/2007; 9(2):109-17. DOI: 10.1016/j.jvc.2007.09.002
Source: PubMed

ABSTRACT

The Amplatz canine duct occluder (ACDO) is a nitinol mesh device with a short waist that separates a flat distal disc from a cupped proximal disc. The device is designed to conform to the morphology of the canine patent ductus arteriosus (PDA). PDA dimensions are determined by angiography, and a guiding catheter is advanced into the main pulmonary artery via the aorta and PDA. An ACDO with a waist diameter approximately twice the angiographic minimal ductal diameter (MDD) is advanced via the catheter using an attached delivery cable until the flat distal disc deploys within the main pulmonary artery. The partially deployed ACDO, guiding catheter, and delivery cable are retracted until the distal disc engages the pulmonic ostium of the PDA. With the delivery cable stabilized, the catheter is retracted to deploy the waist across the pulmonic ostium and cupped proximal disc within the ductal ampulla. Tension on the delivery cable is released, and correct ACDO positioning and stability are confirmed by observing that the device assumes its native shape, back-and-forth maneuvering of the delivery cable, and a small contrast injection made through the guiding catheter. The delivery cable is detached and removed with the guiding catheter. To assess for any residual ductal flow, an angiogram is performed at the conclusion of the procedure, followed by Doppler echocardiography at 1 day and 3 months post-procedure. PDA occlusion in dogs with the ACDO is straightforward and extremely effective across a wide range of body weights, somatotypes, MDDs, and ductal morphologies.

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    • "A distal flat disk positioned on the pulmonary arterial side of the ductal ostium provides secure positioning in the pulmonary artery. As the device is implanted, the proximal cupped disk expands to conform to the shape of the ductal ampulla, with the waist of the device spanning the pulmonic ostium of the ductus and the dense nitinol mesh occluding the communication (Nguyenba and Tobias, 2007). In a retrospective study byGoodrich et al. (2007), SL and TO were considered as acceptable treatments for PDA, with similar procedure times and mortality ra- tes. "
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