CLINICAL APPLICATION OF THE SECOND GENERATION OF AMPLATZER PATENT DUCTUS ARTERIOSUS OCCLUDER IN THE INTERVENTIONAL CLOSURE OF CONGENITAL HEART DISEASE AND CASE SERIES

Background: Some patients with structural heart disease are typically treated or improved by minimally invasive surgeries. Aim: To summarize the efficacy and experience in the treatment of congenital heart disease (CHD) using the second generation of Amplatzer patent ductus arteriosus (ADO- II) occluder. Methods: A total of 37 patients who were admitted to the cardiac surgery department of our hospital from June 2014 to April 2019 were included. After preoperative echocardiography and clinical screening, intraoperative transthoracic echocardiography, and cardiovascular angiography, postoperative echocardiography was carried out to evaluate the incidence of residual shunt and the location and morphology of the ADO-II occluder, as well as postoperative complications. Results: All patients were successfully treated using the ADO-II occluder. There were 27 (73%) cases with patent ductus arteriosus (PDA), as well as 5 (13.5%) cases with ventricular septal defect (VSD), 1 case (2.7%) with VSD combined with PDA, 1 case (2.7%) with aortopulmonary collateral arteries combined with PDA, 1 case (2.7%) with right coronary artery-right atrial fistula, and 2 (5.4%) cases were recanalized after ligation of the main pulmonary artery. All patients had no obvious abnormality in ECG reexamination one month after surgery; The x-ray showed no displacement and shedding, and no long-term significant residual shunt was found in transthoracic echocardiography. No death was reported. Conclusions: The ADO-II occluder is relatively simple to operate, with a high success rate and few complications, and it can be applied to not only PDA occlusion but also to other CHDs, making it worthy of further clinical promotion under the premise of grasping the indicators of interventional therapy.