TY - JOUR
T1 - Initial experience with the amplatzer vascular plug IV in congenital heart disease
T2 - Coronary artery fistula and aortopulmonary collateral artery embolization
AU - MacDonald, Simon T.
AU - Carminati, Mario
AU - Butera, Gianfranco
PY - 2011/3
Y1 - 2011/3
N2 - BACKGROUND: A number of percutaneous devices are available to embolize anomalous vessels in congenital heart disease. We report our initial single-center experience with the new Amplatzer Vascular Plug IV (AVP IV) in congenital heart disease to embolize a coronary artery fistula and aortopulmonary collateral arteries in 4 cases. METHODS: From August 2009 until April 2010, 7 AVP IV devices were deployed in 4 patients, age range 5 months to 9 years, weight 3.5-27.7 kg. One patient had a large coronary artery fistula, the others had anomalous aortopulmonary collaterals; 2 patients had tetralogy of Fallot with pulmonary atresia, with the other having dextrocardia, anomalous pulmonary venous drainage and pulmonary atresia. RESULTS: In all 4 patients, vessels intended to be closed with the AVP IV were closed successfully with minimal residual shunting and no device failures. Deployed devices ranged from 4-8 mm in diameter. One patient had 4 devices, closing large branching infradiaphragmatic aortopulmonary collaterals. The other 3 patients had single devices. Complete vessel embolization was seen with no device embolization or implantation complication. CONCLUSION: This preliminary experience illustrates the utility of the AVP IV in congenital heart disease, occluding a coronary artery fistula and aorto-pulmonary collaterals, with devices between 4 mm and 8 mm in diameter, demonstrating its safety and effectiveness. It is particularly useful in embolizing difficult-to-reach large, tortuous vessels with a small-sized catheter in a single procedure. Longer-term follow up in a larger cohort of patients will be required to establish long-term efficacy and device safety.
AB - BACKGROUND: A number of percutaneous devices are available to embolize anomalous vessels in congenital heart disease. We report our initial single-center experience with the new Amplatzer Vascular Plug IV (AVP IV) in congenital heart disease to embolize a coronary artery fistula and aortopulmonary collateral arteries in 4 cases. METHODS: From August 2009 until April 2010, 7 AVP IV devices were deployed in 4 patients, age range 5 months to 9 years, weight 3.5-27.7 kg. One patient had a large coronary artery fistula, the others had anomalous aortopulmonary collaterals; 2 patients had tetralogy of Fallot with pulmonary atresia, with the other having dextrocardia, anomalous pulmonary venous drainage and pulmonary atresia. RESULTS: In all 4 patients, vessels intended to be closed with the AVP IV were closed successfully with minimal residual shunting and no device failures. Deployed devices ranged from 4-8 mm in diameter. One patient had 4 devices, closing large branching infradiaphragmatic aortopulmonary collaterals. The other 3 patients had single devices. Complete vessel embolization was seen with no device embolization or implantation complication. CONCLUSION: This preliminary experience illustrates the utility of the AVP IV in congenital heart disease, occluding a coronary artery fistula and aorto-pulmonary collaterals, with devices between 4 mm and 8 mm in diameter, demonstrating its safety and effectiveness. It is particularly useful in embolizing difficult-to-reach large, tortuous vessels with a small-sized catheter in a single procedure. Longer-term follow up in a larger cohort of patients will be required to establish long-term efficacy and device safety.
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M3 - Article
C2 - 21364243
AN - SCOPUS:79960097316
VL - 23
SP - 120
EP - 124
JO - Journal of Invasive Cardiology
JF - Journal of Invasive Cardiology
SN - 1042-3931
IS - 3
ER -