Patent ductus arteriosus occlusion in small dogs utilizing a low profile Amplatz® canine duct occluder prototype

ObjectivesTo develop procedural methodology and assess the safety, utility and effectiveness of a low profile Amplatz® canine duct occluder (ACDO) prototype in dogs deemed too small to undergo ductal occlusion with the commercially-available ACDO device.AnimalsTwenty-one dogs with left-to-right shunting patent ductus arteriosus (PDA). Dogs were ≥1.5 kg but considered too small to accommodate a 6 Fr catheter or 4 Fr sheath within the femoral artery.MethodsProspective canine study using a low profile ACDO prototype delivered through a 4 Fr catheter via a femoral arterial approach. Procedural methods, fluoroscopy time, perioperative complications, and residual ductal flow were evaluated, and angiographic ductal morphology and dimensions were tabulated.ResultsAll 21 dogs underwent successful ductal occlusion using the prototype device, 4 Fr catheter, and right femoral artery approach. No perioperative complications or device embolization occurred. The median minimal ductal diameter was 1.9 mm (range, 0.4–3.4), and the median device size deployed was 4 mm (range, 3–6). Complete ductal occlusion was noted in 17 dogs (81%) on post-deployment angiography. Twenty dogs (95%) had no residual flow on echocardiography performed the following day. In the 17 dogs (81%) that returned for a long-term (≥3months) follow-up evaluation, all had complete ductal occlusion based on echocardiography.ConclusionsThe low profile ACDO prototype is a safe and effective method of PDA occlusion in the small dog. The deployment procedure appears of similar technical difficulty to the commercially available ACDO.