ORIGINAL ARTICLE Update on the Amplatzer Duct Occluder: A 10-Year Experience in Asia Charles C. Cuaso • Reina Bianca M. Tan • Jonas D. Del Rosario • Dexter D. Cheng • Karl G. Reyes Received: 3 July 2011 / Accepted: 3 November 2011 / Published online: 22 November 2011 Ó Springer Science+Business Media, LLC 2011 Abstract Few data exist regarding the efficacy and safety of the Amplatzer ductal occluder (ADO) type 1 device in the Asian region. This retrospective study, conducted between August 2001 and April 2011, attempted device placement for 231 patients (165 females and 66 males) with a median age of 7.4 years (range, 3 months to 64 years) and an average weight of 19.4 kg (range, 4.1–81.0 kg). Among the patients in this study, 66 (28.6%) had pulmonary hyper- tension, ten (4.3%) had trisomy 21, and eight (3.5%) had other congenital cardiac anomalies. The mean narrowest patent ductus arteriosus (PDA) diameter was 4.2 mm (range, 1.3–10 mm), and the ampulla size was 9.6 mm (range, 4–20 mm). Successful implantation was achieved for 229 patients (99.1%). Complete angiographic occlusion was achieved for 201 patients (87.8%) at the end the pro- cedure. Follow-up data were available for 129 patients (66%). At the follow-up assessment, complete echocardio- graphic occlusion was seen in 128 patients (99.2%) after 1 month and in 100% of the patients after 6 months. The significant morbidities involved one device emboliza- tion and one dislodgment, for which surgical retrieval was performed. No mortalities occurred during the study period, and no late clinical adverse events occurred during the fol- low-up period. Occlusion of the PDA using ADO is safe, effective, and applicable for a wide range of PDA sizes including large PDAs in small symptomatic infants and in adults. Good outcomes can be attributed to experience of the operators, proper patient selection, and appropriate device size selection. Keywords Patent ductus arteriosus Á Amplatzer duct occluder Á Congenital heart disease Patent ductus arteriosus (PDA) was one of the first con- genital heart diseases to be treated via the transcatheter technique. The first reported interventional closure was by Portsmann et al. [12] in 1971, followed by that of Rashkind and Cuaso [13]. Since then, various devices have been used, such as the Gianturco coils (Cook Cardiology, Bloomington, IN, USA), detachable coils (Cook Cardiol- ogy), Flipper coils (Cook Cardiology), Duct-Occlud (PFM, Cologne, Gemany), and Nit-Occlud (PFM) [1, 2, 5, 7, 9– 11, 18]. In 1998, the Amplatzer duct occluder (ADO; AGA Med Corp, MN) was introduced, which has become the most frequently used device for closure of moderate to large PDAs [1, 3–6, 8, 9, 15–20]. Currently, transcatheter closure of PDA is an established procedure that is increasingly used as the procedure of choice for most patients, including those in developing nations. Follow-up data from Western countries have been published, but sparse data are reported for Asian popula- tions. We report the results of Amplatzer ductal occluder device closure in the Philippines, as well as the C. C. Cuaso Section of Congenital Cardiology, St. Luke’s Medical Center, Quezon City, Philippines R. B. M. Tan Department of Pediatrics, State University of New York, Downstate Medical Center, Brooklyn, NY, USA J. D. Del Rosario Á D. D. Cheng Department of Pediatrics, Section of Pediatric Cardiology, Philippine General Hospital, Manila, Philippines K. G. Reyes (&) Department of Thoracic and Cardiovascular Surgery, St. Luke’s Medical Center and College of Medicine, 279 E. Rodriguez Avenue, 1112 Quezon City, Metro Manila, Philippines e-mail: kgreyes@stluke.com.ph 123 Pediatr Cardiol (2012) 33:533–538 DOI 10.1007/s00246-011-0145-z