Transcatheter Amplatz canine duct occluder placement for patent ductus arteriosus occlusion: A retrospective analysis of outcomes and complications in 200 dogs

Introduction: The Amplatz canine duct occluder (ACDO) is routinely used for patent ductus arteriosus (PDA) occlusion. Limited data are available on clinical outcomes and success rates with ACDO device placement. This study aimed to determine procedural outcome and complications for PDA occlusion with the ACDO in a large cohort of dogs. Animals, Materials, and Methods: A retrospective study of 200 dogs that underwent ACDO placement for PDA occlusion between March 2007- and September 2023 was conducted. Transthoracic echocardiography was performed prior to occlusion, 24 h after occlusion, and during follow-up recheck visits. Procedural success was defined as successful device placement as determined based on fluoroscopy at the time of the PDA occlusion procedure and survival after the procedure. Results: Dogs had a median weight of 6.5 kg and required a median device size of 6 mm. At 24 h post- occlusion, 5% of dogs had trivial flow through the device. Persistent trivial flow was noted on recheck in 5.5% of patients with a median follow-up time of 96 days. Minor complications occurred in 2.5% of dogs. Major complications occurred in 4% of dogs including device embolization in 2% of dogs. Procedural mortality rate was 0.5%. There was a statistically significant reduction in left ventricular and left atrial size at the 24-h postocclusion recheck echocardiogram (P<0.001) and at follow-up rechecks (P<0.001). There was a statistical difference (P<0.050) between echocardiographic and angiographicderived measurements and ratios when selecting device size. Conclusions: The high procedural success and low complication rates support use of the ACDO device as a safe and effective method of PDA occlusion in dogs.