{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,21]],"date-time":"2025-09-21T18:05:44Z","timestamp":1758477944864,"version":"3.41.0"},"reference-count":9,"publisher":"Cambridge University Press (CUP)","issue":"4","license":[{"start":{"date-parts":[[2006,7,14]],"date-time":"2006-07-14T00:00:00Z","timestamp":1152835200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cardiol Young"],"published-print":{"date-parts":[[2006,8]]},"abstract":"<jats:p><jats:italic>Objective<\/jats:italic>: To establish the feasibility and efficacy of closing large patent arterial duct in infants, using the modified and angled variants of the Amplatzer duct occluder. <jats:italic>Background<\/jats:italic>: Closure of large patent arterial ducts by inserting devices in sick and underweight infants, particularly those weighing around 5 kilograms, remains a challenge. Bigger devices require larger delivery sheaths and may cause obstruction either to the aorta or left pulmonary artery. Negotiating a large device is difficult or impossible, as the sheath gets kinked. Because of these problems, such underweight infants with large ducts who are failing to thrive, and in left ventricular failure with associated lesions, are typically referred for surgery, often leading to higher morbidity and mortality. <jats:italic>Methods<\/jats:italic>: We attempted to close such large patent arterial ducts using the new Amplatzer occluder, modified with single layer of polyester, and the angled occluder, with no polyester material, inserted through a specially braided kink-resistant sheath. <jats:italic>Results<\/jats:italic>: Closure was achieved in 10 infants, with mean age of 8.2 months, mean weight of 5.5 kilograms, the lowest weighing 3.9 kilograms. The mean size of the patent ducts was 6.3 millimetres, with the largest measuring 8.6 millimetres. We implanted 6 modified and 4 angled occluders. In one patient, suffering from hydronephrosis, a 14\/12 angled device embolized and was retrieved, but the patient died. In the remaining patients, all ducts were closed completely, with no obstruction to either the aorta or left pulmonary artery. On follow up, all showed excellent clinical improvement. <jats:italic>Conclusion<\/jats:italic>: Complete closure of very large patent arterial ducts is now possible, even in very sick and underweight infants, using the large but low profile custom-made angled or modified versions of the Amplatzer occluder.<\/jats:p>","DOI":"10.1017\/s1047951106000394","type":"journal-article","created":{"date-parts":[[2006,7,14]],"date-time":"2006-07-14T12:59:27Z","timestamp":1152881967000},"page":"378-384","source":"Crossref","is-referenced-by-count":12,"title":["Initial clinical experience in transcatheter closure of large patent arterial ducts in infants using the modified and angled Amplatzler duct occluder"],"prefix":"10.1017","volume":"16","author":[{"given":"Ishwarappa B.","family":"Vijayalakshmi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Narasimhan","family":"Chitra","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ravindran","family":"Rajasri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karthik","family":"Vasudevan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2006,7,14]]},"reference":[{"key":"S1047951106000394_ref005","doi-asserted-by":"crossref","unstructured":"Krichenko A , Benson LN , Burrows P , Moes CA , McLaughlin P , Freedom RM . Angiographic classification of the isolated, persistently patent ductus arteriosus and implications for percutaneous catheter occlusion. Am J Cardiol 1989; 63: 877\u2013880.","DOI":"10.1016\/0002-9149(89)90064-7"},{"key":"S1047951106000394_ref006","doi-asserted-by":"crossref","unstructured":"Gross RE , Hubbard JP . Surgical ligation of a patent ductus arteriosus: report of first successful case. JAMA 1939; 112: 729\u2013731.","DOI":"10.1001\/jama.1939.02800080049011"},{"key":"S1047951106000394_ref004","doi-asserted-by":"crossref","unstructured":"Duke C , Chan KC . Aortic obstruction caused by device occlusion of patent arterial duct. Heart 1999; 82: 109\u2013111.","DOI":"10.1136\/hrt.82.1.109"},{"key":"S1047951106000394_ref001","doi-asserted-by":"crossref","unstructured":"Hijazi ZM , Geggel RL . Results of anterograde transcatheter closure of patent ductus arteriosus using single or multiple Gianturco coils. Am J Cardiol 1994; 74: 925\u2013929.","DOI":"10.1016\/0002-9149(94)90588-6"},{"key":"S1047951106000394_ref002","doi-asserted-by":"crossref","unstructured":"Bilkis AA , Alwi M , Hasri S et al. The Amplatzer duct occluder: experience in 209 patients. J Am Coll Cardiol 2001; 37: 258\u2013261.","DOI":"10.1016\/S0735-1097(00)01094-9"},{"key":"S1047951106000394_ref003","doi-asserted-by":"crossref","unstructured":"Faella HJ , Hijazi ZM . Closure of the patent ductus arteriosus with the Amplatzer PDA device: immediate results of the international clinical trial. Catheter Cardiovasc Interv 2000; 51: 50\u201354.","DOI":"10.1002\/1522-726X(200009)51:1<50::AID-CCD11>3.0.CO;2-6"},{"key":"S1047951106000394_ref008","doi-asserted-by":"crossref","unstructured":"Ewert P , Kretschmar O , Nuernberg JH , Nagdyman N , Lange PE . First closure of a large patent ductus arteriosus in an infant with an angulated nitinol plug. Catheter Cardiovasc Interv 2002; 57: 88\u201391.","DOI":"10.1002\/ccd.10270"},{"key":"S1047951106000394_ref007","doi-asserted-by":"crossref","unstructured":"Fischer G , Stieh J , Uebing A , Grabitz R , Kramer HH . Transcatheter closure of persistent ductus arteriosus in infants using the Amplatzer duct occluder. Heart 2001; 86: 444\u2013447.","DOI":"10.1136\/heart.86.4.444"},{"key":"S1047951106000394_ref009","doi-asserted-by":"crossref","unstructured":"Masura J , Gavora P , Podnar T . Transcatheter occlusion of patent ductus arteriosus using a new angled Amplatzer duct occluder: initial clinical experience. Catheter Cardiovasc Interv 2003; 58: 261\u2013267.","DOI":"10.1002\/ccd.10413"}],"container-title":["Cardiology in the Young"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1047951106000394","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,21]],"date-time":"2025-06-21T00:32:56Z","timestamp":1750465976000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1047951106000394\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2006,7,14]]},"references-count":9,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2006,2]]}},"alternative-id":["S1047951106000394"],"URL":"https:\/\/doi.org\/10.1017\/s1047951106000394","relation":{},"ISSN":["1047-9511","1467-1107"],"issn-type":[{"type":"print","value":"1047-9511"},{"type":"electronic","value":"1467-1107"}],"subject":[],"published":{"date-parts":[[2006,7,14]]}}}