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


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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    ABSTRACT: Patent ductus arteriosus (PDA) is one of the most common congenital vascular abnormalities in the dog. In veterinary medicine, surgical ligation (SL) and transarterial occlusion (TO) are two possible treatments that require general anesthesia. Two 4-month-old dogs were anesthetized for the correction of PDA, one by SL and the other by TO. Two different anesthetic and analgesic protocols were used, and were chosen to avoid potential complications. This case report describes two possible anesthetic approaches for PDA corrective surgery (SL and TO).
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    ABSTRACT: This study was designed to evaluate the feasibility and limitations of transcatheter embolization coil occlusion of patent ductus arteriosus in dogs using a carotid artery approach. Seven dogs examined at the University of California, Davis Veterinary Medical Teaching Hospital in 2002-2003 for evaluation of heart disease had congenital patent ductus arteriosus diagnosed by characteristic physical, electrocardiographic, radiographic, and anatomic and Doppler echocardiographic findings. Dogs were anesthetized for transesophageal echocardiography and transcatheter coil embolization of the ductus via the right external carotid artery. Coil embolization was achieved in all seven cases, using one to four detachable embolization coils. There were no major complications. Minor complications occurred in two dogs (additional coils placed using a femoral arterial approach and coil embolization of a left femoral artery branch). One dog was examined only 24 h post-operatively and had no murmur and trivial residual ductal flow by Doppler echocardiography. The other 6 dogs were clinically healthy when examined up to three years post-intervention. One dog had a very soft continuous murmur and mild residual ductal flow; the other five had no audible continuous murmur, with only one dog having trivial residual ductal flow identified by Doppler echocardiography. Although technically challenging, coil embolization via the carotid artery is a viable alternative approach for transcatheter closure of patent ductus arteriosus in some dogs.
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