Malfunction of an Oversized Amplatzer Ductal Occluder Presenting as Aortic Coarctation: A Case Report
Abstract
Introduction: This case report discusses the malfunction of an oversized Amplatzer Ductal Occluder device, which presented clinically as aortic coarctation.
Case Presentation: Patient with Patent Ductus Arteriosus (PDA) underwent treatment with the placement of an Amplatzer Ductal Occluder. Following procedure, patient presented with decreased oxygen saturation in lower extremity, up to 80%. Catheterization revealed a significant pressure difference between the proximal and distal aorta. Post-ADO placement, the proximal aortic pressure increased to 83/34 (57) mmHg, while the distal aortic pressure dropped significantly to 43/33 (38) mmHg, indicating a substantial pressure gradient caused by the oversized device.
Management: In response to the hemodynamic compromise, the patient underwent an emergency left thoracotomy for the removal of the Amplatzer device and PDA ligation. The surgical intervention was performed to address the obstruction and restore normal blood flow. Post-operatively, the patient was admitted to the Intensive Care Unit and underwent Heparinization. The patient's hemodynamics were stable and oxygen saturation levels in the lower extremities showed improvement.
Discussion: The oversized Amplatzer device likely caused an obstruction that mimicked aortic coarctation, resulting in significant hemodynamic changes. Timing of surgical intervention was crucial in preventing further complications. This case highlights the importance of accurate device sizing during PDA closure procedures to avoid such adverse outcomes.
Conclusion: Oversizing of the Amplatzer Ductal Occluder can lead to significant hemodynamic changes and clinical deterioration. Accurate sizing and prompt surgical intervention are essential in managing and preventing complications
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Copyright (c) 2025 Gusti Ramadani, Heroe Soebroto, Arief Rakhman Hakim, Hari Daswin Pagehgiri

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