Alternate uses of PDA occluders to close cardiac and extra cardiac defects

  • Dr Anil Sivadasan, Department of Pediatric Cardiology, Apollo Health City, Hyderabad, India
  • Dr Girish Navasundi, Department of Pediatric Cardiology, Apollo Health City, Hyderabad, India
  • Dr Kanhaiya Jeswani, Department of Pediatric Cardiology, Apollo Health City, Hyderabad, India
  • Dr Deepa Sharma, Department of Pediatric Cardiology, Apollo Health City, Hyderabad, India
  • Dr Meena Trehan, Department of Pediatric Cardiology, Apollo Health City, Hyderabad, India
  • Dr S Sunil, Department of Pediatric Cardiology, Apollo Health City, Hyderabad, India
  • Dr Biswajit Bandopadhya, Rabindranath Tagore International Institute of Cardiac Sciences,Kolkata, India
  • Dr Ashutosh Raghuvanshi, Rabindranath Tagore International Institute of Cardiac Sciences,Kolkata, India

    • We describe the use of PDA occluder to close intra and extra cardiac defects different from its intended use.These were used for closure of aorto pulmonary window(1),Blalock Taussig shunt(1),coronary AV fistula(3),rupture of sinus of valsalva aneurysm-(2),Muscular VSD(3) and MAPCA(1).We used either Amplatzer (ADO)or a Lifetech occluder(LDO).
    1.A 3 year old boy with 6mm distal APW was closed using a 8-6mm LDO.2.A 6mm modified BT shunt which was unligated after intracardiac repair in a 28 year old woman was blocked with a 10-8 ADO.3Three patients underwent closure of coronary AV fistula, two had fistula from RCA and were blocked with 6-4 ADO and 8-6 LDO. The third had a fistula from the LMCA and was occluded with 6-4 mm ADO.A 5 year old boy had a RSOV aneurysm into left ventricle and this was from the venous end after transeptal puncture of the interatrial septum. The defect was closed with 10-8 ADO with no residual flow. Three patients with muscular VSD underwent closure. One had a 5mm anterior muscular VSD with mild PAH and was closed with 10-8 ADO. The other two patients had posterior muscular VSD which were closed with 8-6 LDO device. A 7 year old boy with VSD-PA after unifocalization and intracardiac repair with conduit,developed recurrent pleural effusions. one large MAPCA draining directly to RPA and was closed with 10-8 ADO.
    Conclusions:
    Transcatheter closure of cardiac and extra cardiac defects can be safely and effectively accomplished with PDA occluders and offers good alternative to surgical treatment.