Transcatheter closure of tubular patent ductus arteriosus using muscular ventricular septal defect devices in infants and small children with congestive heart failure

Background. - Transcatheter closure of a patent ductus arteriosus in children is widely performed to reduce symptoms and decrease the risk of endocarditis. Most arterial ducts are closed successfully with dedicated devices. However, in a tubular or "type C'' patent ductus with congestive heart failure, the occlusion is more challenging with these devices, with a higher risk of complications, such as aortic or left pulmonary stenosis and deviceembolization.Aim. - To report our experience with muscular ventricular septal defect devices for patentductus arteriosus occlusion in small children.Methods. - Retrospective observational series of patients weighing < 10 kg, with a tubularpatent ductus arteriosus (type C) and congestive heart failure, who underwent transcatheterclosure with a muscular ventricular septal defect device between 2017 and 2019.Results. - Eight patients were included. The mean age and weight at closure were 6.3 months( range 1-18 months) and 5.3 kg (range 2.4-8.2 kg), respectively. All patent ductus arteriosuswere occluded successfully using Occlutech (R) (N = 3) or Amplatzer (R) (N = 5) muscular ventricularseptal defect devices. In four cases, the muscular ventricular septal defect device was used afterfailure to close the patent ductus arteriosus with a dedicated patent ductus arteriosus device. Two patients had mild left pulmonary artery stenosis, with a maximum velocity on continuousDoppler of 3 m/s and 2.7 m/s, respectively. After a mean follow-up of 28 months (range 14-41months), all patients were asymptomatic with excellent results. The mild pulmonary stenosisimproved, with a maximum velocity of 2.3 m/s in both patients.Conclusions. - Closure of tubular patent ductus arteriosus in small children with congestiveheart failure using a muscular ventricular septal defect device is safe in this preliminary experience. Further studies with more patients are warranted. (c) 2022 Published by Elsevier Masson SAS.