The amplatzer vascular plug and amplatzer vascular plug II for vascular occlusion procedures in 50 patients with congenital cardiovascular disease

Objective: To describe the use of the amplatzer vascular plug (plug 1) and amplatzer vascular plug II (plug 2) in patients with congenital cardiovascular disease (CCVD). Background: Plugs 1 and 2 have recently been made available. We report our experience describing plugs 1 and 2 in patients with CCVD highlighting the versatility of these devices. Methods: All patients with CCVD who underwent a vascular occlusion procedure at the Children's Hospital of Philadelphia between August 1, 2004 and July 30, 2009 with plug 1 or 2 were included. A retrospective review was performed. Results: Fifty patients underwent vascular occlusion procedure with plug 1 or 2 at a median age of 2.0 years (range 1 day to 47 years) and median weight of 12.3 kg (range 3.1-98 kg). Fifty-eight plugs (43% plug 1, 57% plug 2) were placed in 52 vessels. Of these vessels, 20 (38%) were patent ductus arteriosus (PDA), 14 (27%) venous collaterals, 5 (10%) aorto-pulmonary collaterals, 4 (8%) modified Blalock Taussig shunts, 3 (5%) porto-systemic connections, and 6 (12%) miscellaneous structures. Excluding a patient who was lost to follow-up, complete occlusion was observed in 100% of vessels either at the time of the catheterization or at follow-up. There were two complications (3.8%). Conclusions: Plugs 1 and 2 are safe and effective devices that can be used in a variety of blood vessels in patients with CCVD. Plug 2 is particularly useful in closure of high-flow, tubular structures, especially type C PDA's.