Transcatheter closure of small ductus arteriosus with amplatzer vascular plug

Purpose: The purpose of this study was to share our experience of transcatheter closure of small patent ductus arteriosus (PDA) by using an Amplatzer vascular plug (AVP). Methods: We reviewed the medical records of 20 patients who underwent transcatheter closure at Samsung Medical Center and Sejong General Hospital from January 2008 to August 2012. The size and shape of the PDAs were evaluated by performing angiograms, and the PDA size and the AVP devices size were compared. Results: The mean age of the patients was $54.9{\pm}45.7$ months old. The PDAs were of type C (n=5), type D (n=12), and type E (n=3). The mean pulmonary end diameter of the PDA was $1.7{\pm}0.6$ mm, and the aortic end diameter was $3.6{\pm}1.4$ mm. The mean length was $7.3{\pm}1.8$ mm. We used 3 types of AVP devices: AVP I (n=5), AVP II (n=7), and AVP IV (n=8). The ratio of AVP size to the pulmonary end diameter was $3.37{\pm}1.64$, and AVP size/aortic end ratio was $1.72{\pm}0.97$. The aortic end diameter was significantly larger in those cases repaired with AVP II than in the others (P=0.002). The AVP size did not significantly correlate with the PDA size, but did correlate with smaller ratio of AVP size to aortic end diameter ($1.10{\pm}0.31$, P=0.032). Conclusion: Transcatheter closure of small PDA with AVP devices yielded satisfactory outcome. AVP II was equally effective with smaller size of device, compared to others.