Displaying publications 1 - 20 of 28 in total

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  1. Alwi M, Kang LM, Samion H, Latiff HA, Kandavel G, Zambahari R
    Am J Cardiol, 1997 May 15;79(10):1430-2.
    PMID: 9165178 DOI: 10.1016/s0002-9149(97)00160-4
    Two hundred eleven patients with small- to moderate-sized native patent ductus arteriosus underwent closure using Gianturco coils, employing the transvenous multiple catheter approach. Short-term results showed a high rate of complete occlusion and a potential long-term complication of mild left pulmonary artery stenosis in a small number of patients.
    Matched MeSH terms: Ductus Arteriosus, Patent/therapy*
  2. Boo NY, Mohd-Amin I, Bilkis AA, Yong-Junina F
    Singapore Med J, 2006 Sep;47(9):763-8.
    PMID: 16924357
    Introduction: The aim of this study was to determine predictors of failed closure of patent ductus arteriosus (PDA) following a single course of indomethacin in symptomatic preterm infants.
    Methods: This prospective observational study was carried out on 60 preterm infants weighing less than 1,750 g with symptomatic PDA confirmed by echocardiography. At a median age of 7.0 days (interquartile range 4.0), they were given indomethacin of 0.1 mg/kg/day intravenously daily for six days. Closure of PDA was reassessed by echocardiography upon completion of therapy.
    Results: The PDA of 40 percent (n=24) of these infants remained patent. Forward logistic regression analysis showed that the only significant predictors of failed PDA closure in these infants were: PDA size (adjusted odds-ratio [OR] is 7.0; 95 percent confidence interval [CI] of OR is 2.0, 24.8; p-value is 0.002), birth weight (adjusted OR is 0.996; 95 percent CI of OR is 0.993, 1.000; p-value is 0.03) and platelet count (adjusted OR is 0.987; 95 percent CI is 0.975, 1.000; p-value is 0.045). Gestational age, maternal age and left atrium/aorta ratios were not significant predictors.
    Conclusion: Larger PDA, lower birth weight and lower platelet count were significant predictors of high failure in indomethacin therapy given late at one week of life.
    Matched MeSH terms: Ductus Arteriosus, Patent/drug therapy*; Ductus Arteriosus, Patent/ultrasonography
  3. Chye JK, Lim CT, Leong HL, Wong PK
    Ann Acad Med Singap, 1999 Mar;28(2):193-8.
    PMID: 10497665
    This study aims to determine the prevalence of and risk factors associated with retinopathy of prematurity (ROP) in very low birth weight (VLBW) infants. All premature VLBW infants, admitted into the neonatal intensive care unit of the University Hospital Kuala Lumpur, were screened from 4 weeks of life. Perinatal and neonatal data were retrieved from the infants' medical notes. Between August 1994 and July 1996, 100 infants had their eyes examined serially. Of the 15 (15%) infants with ROP, all were less than 31 weeks gestation, and only 1 infant had birth weight above 1250 g. Five (5%) infants had severe ROP; 4 infants underwent cryotherapy for stage 3 threshold disease. Infants with ROP, as compared to infants without ROP, had lower birth weight [mean (SEM) 993 (50) g versus 1205 (22) g, P < 0.001], lower gestational age [mean (SEM) 28.0 (0.4) weeks versus 30.1 (0.2) weeks, P < 0.001], higher rates of patent ductus arteriosus and chronic lung disease, greater number of radiographic examinations and episodes of late-onset suspected/confirmed sepsis, and required longer duration of supplemental oxygen, ventilation, xanthine, antibiotics and intralipid use, but were slower to establish full enteral feeds. On multivariate logistic regression analysis, birth weight < or = 1000 g [OR 2.38, 95% CI 1.25, 4.55, P = 0.009] and gestational age < or = 28 weeks [OR 2.86, 95% CI 1.47, 5.56, P = 0.002] were significant predictors of increased risk of this disease. In conclusion, ROP is strongly associated with smaller, more immature and sicker neonates. Prevention of prematurity would help reduce the incidence of this disease.
    Matched MeSH terms: Ductus Arteriosus, Patent/epidemiology
  4. Singham KT, Wong HO
    Aust N Z J Med, 1979 Apr;9(2):174-6.
    PMID: 287460 DOI: 10.1111/j.1445-5994.1979.tb04323.x
    Findings are reviewed of isolated Patent Ductus Arteriosus after infancy as seen in 181 patients studied at the University Hospital, Kuala Lumpur, during the period 1967 to 1975. The ages of patients ranged from nine months to 54 years. Eighty-two patients underwent cardiac catheterization. More than 50% of patients were above ten years of age; the sex ratio was 1 male: 2.93 females. Thirty-two per cent of the patients had significant effort dyspnoea or were in heart failure. The complications noted were elevated pulmonary vascular resistance, Eisenmenger syndrome, bacterial endocarditis and cardiac failure.
    Matched MeSH terms: Ductus Arteriosus, Patent/complications*; Ductus Arteriosus, Patent/diagnosis
  5. Tan CTT
    Med J Malaysia, 1987 Jun;42(2):104-9.
    PMID: 3503182
    Surgery for the persistent ductus arteriosus (PDA) is almost 50-years-old. It started with Robert Gross in 1938 who successfully ligated the PDA in a seven-year-old girl.! Incomplete obliteration, ligatures cutting through the ductus and recanalisation of the ductus remained troublesome possibilities with this method of dealing with the PDA. Dividing the ductus and suturing each divided end separately would eliminate these possibilities. Gross was quick to recognise this and advocated division in all cases to remove any doubt of incomplete obliteration. 2 Jones supported this concept but also stressed that division and suture of the PDA was not to be taken lightly for the fatal consequence that could arise from inexperience.f There were those who continued to have satisfactory results with ligation of the PDA and persisted with this method (Blalock." Clagett, Kirklin, Ellis and Coolev.' Panagopoulos, Tatooles, Aberdeen, Waterston and Bonham Carter"}, The debate continues between ligation on one hand, and division and suture on the other and it appears currently to favour the latter. This paper reviews our experience with surgery for the PDA over the past five years.
    Matched MeSH terms: Ductus Arteriosus, Patent/surgery*
  6. Krishnan M, Snelling MR
    Br Heart J, 1971 Sep;33(5):699-701.
    PMID: 5115012 DOI: 10.1136/hrt.33.5.699
    Matched MeSH terms: Ductus Arteriosus, Patent/diagnosis; Ductus Arteriosus, Patent/radiography; Ductus Arteriosus, Patent/surgery*
  7. Amir Hamzah AR, Tiow CA, Koh GT, Sharifah AM
    Med J Malaysia, 2011 Mar;66(1):19-21.
    PMID: 23765137
    Transcatheter closure of small and moderate sizes of Patent Ductus Arteriosus (PDA) is a standard and well accepted form of treatment. The aim of this study is to describe the experience of transcatheter closure of PDA in Penang Hospital. All patients who underwent transcatheter closure of PDA at our institution between 20th January 2006 and 27th June 2008 were retrospectively identified and studied. There were a total of 66 patients who had undergone transcatheter closure of PDA during this period which comprised of 24 male and 42 female. The PDA was closed by Amplatzer Duct Occluder (ADO) in 31 patients, Gianturco coil in 29 patients and other types of devices in 6 patients. There were 4 patients (6%) who had developed acute complication during the procedure (3 of them developed coil embolization and 1 had bleeding from puncture site). The PDA was successfully close in 95.5% of the study population without any residual PDA shunting. All the patients were alive but 5 of them (4.5%) have some abnormalities (2 has mild left pulmonary stenosis, 3 has small residual). Comparison between ADO and Gianturco coil revealed no significant difference in the outcome. Transcatheter closure of PDA has proven to be safe and effective with good midterm outcome. There was no significant difference between Amplatzer Ductal Occluder and Gianturco coil in term of the outcome.
    Matched MeSH terms: Ductus Arteriosus, Patent*
  8. Ahzad Hadi Ahmad, Rabiatul Basria S.M.N. Mydin, Nur Ain Nisrina Roan, Abdul Rahman Azhari, Narazah Mohd Yusoff
    MyJurnal
    Advanced parental age is a risk factor for chromosomal abnormalities in their offspring. Trisomy X or Triple X syn- drome has previously been reported with advanced maternal age. Here we report two (2) cases of Trisomy X with paternal age as risk factor. Generally, Trisomy X individuals show variable physical and psychological manifesta- tions. However, both cases reported here have advanced paternal age as a risk factor; 55 years old (46 years old at conception) for Case 1 with patient having right eye squint, beaked nose, Posterior Misalignment Type Ventricular Septal Defect (PMVSD) and small Patent Ductus Arteriosus (PDA) with failure to thrive and 49 years old (45 years old at conception) for Case 2 with speech delay and protruding tongue. In view of that, advanced paternal age could possibly contribute the accumulation of de novo mutations in germ line mosaicism.

    Matched MeSH terms: Ductus Arteriosus, Patent
  9. Alwi M, Choo KK, Latiff HA, Kandavello G, Samion H, Mulyadi MD
    J Am Coll Cardiol, 2004 Jul 21;44(2):438-45.
    PMID: 15261945 DOI: 10.1016/j.jacc.2004.03.066
    Objectives: This study was designed to assess the safety, efficacy, medium-term outcome, and complications of patent ductus arteriosus (PDA) stenting in duct-dependent pulmonary circulation.
    Background: Patent ductus arteriosus stenting has been proposed as an alternative to surgical shunt on account of postoperative morbidity and complications of surgical shunting.
    Methods: Between April 2000 and February 2003, 69 patients with duct-dependent pulmonary circulation underwent cardiac catheterization with the intent of PDA stenting as first palliative procedure. Patients with critical pulmonary stenosis and pulmonary atresia with intact ventricular septum post-radiofrequency valvotomy who had PDA stenting were excluded. Thirteen more patients were excluded because of branch pulmonary artery (PA) stenosis. The follow-up was by clinical examination, echocardiography, and repeat cardiac catheterization at six to nine months following the procedure.
    Results: Patent ductus arteriosus stenting was successful in 51 patients (91.1%) and failed in 5 patients (8.9%). The mean narrowest PDA diameter was 1.9 +/- 0.6 mm. The mean procedure and fluoroscopy time were 95.7 min and 29.4 min, respectively. In one patient the stent dislodged and migrated to the left femoral artery and another patient developed transient intravascular hemolysis. There was no procedure-related mortality. Three patients (5.9%) died one day to two months after the procedure. At follow-up (3.2 months to 2.4 years), 8 patients developed significant stent stenosis requiring reintervention. Seven patients developed worsening of preexisting branch PA stenosis. The freedom from reintervention was 89% and 55% at 6 months and 1 year, respectively.
    Conclusions: Patent ductus arteriosus stenting is an attractive alternative to surgical shunt in a majority of patients with duct-dependent circulation. An absolute contraindication to this technique is the presence of branch pulmonary stenosis.
    Matched MeSH terms: Ductus Arteriosus, Patent/physiopathology; Ductus Arteriosus, Patent/radiography; Ductus Arteriosus, Patent/therapy*
  10. Alwi M, Mood MC
    Interv Cardiol Clin, 2013 Jan;2(1):93-113.
    PMID: 28581990 DOI: 10.1016/j.iccl.2012.09.011
    Stenting of patent ductus arteriosus (PDA) is an attractive alternative to the surgical aortopulmonary shunt in the palliation of cyanotic congenital heart disease. However, the diverse morphology of PDA in this setting limits its role, as stenting an overly tortuous duct may not be feasible, and in a significant number of patients, ductus-related pulmonary artery stenosis contraindicates this procedure. The major acute complications are stent migration, thrombosis, and cardiac failure. Early failure of palliation caused by in-stent stenosis is another limitation of this procedure.

    Study site: Institut Jantung Negara (IJN), Kuala Lumpur, Malaysia
    Matched MeSH terms: Ductus Arteriosus, Patent
  11. Zarin Ikmal ZZ, Wan Azman WM, Asma O, Mazeni A
    JUMMEC, 2000;5:45-47.
    Six patients underwent transcatheter closure of patent ductus arteriosus (PDA) using either conventional Gianturco coils or the Amplatzer Ductal Occluder (ADO) device. All patients were females with a median age of 23.3 (range 4 to 26 years). The mean PDA size measured on the lateral aortogram was 3.81mm (range 2.3-5.83mm). Complete closure of the PDA was achieved in all patients.
    Matched MeSH terms: Ductus Arteriosus, Patent
  12. Majid AA
    Chest, 1993 May;103(5):1512-4.
    PMID: 8486035 DOI: 10.1378/chest.103.5.1512
    This article describes a technique which allows the patent ductus arteriosus (PDA) to be closed through a minithoracotomy. It combines a simple method of inducing atelectasis with Ligaclip closure of the PDA through a subaxillary incision. It was used successfully in 11 children and adolescents.
    Matched MeSH terms: Ductus Arteriosus, Patent/surgery*
  13. Kareem BA, Kamarulzaman H, Koh GT
    Ann Thorac Surg, 2010 Nov;90(5):1703-5.
    PMID: 20971300 DOI: 10.1016/j.athoracsur.2010.04.105
    A 9-year-old boy with patent ductus arteriosus complicated by infective endocarditis had not responded to antibiotic therapy and was referred to our institution. He had persistent fever and a chest roentgenogram demonstrated the presence of left lung pneumonic consolidation. An echocardiogram showed the presence of large vegetation in the pulmonary artery at the ductal opening. We successfully performed an open ductal ligation with the aid of cardiopulmonary bypass through a sternotomy and proceeded to resect the vegetation. We completed the procedure with reconstruction of the pulmonary artery. The postoperative course was uneventful. The patient was discharged after a week.
    Matched MeSH terms: Ductus Arteriosus, Patent/surgery*
  14. Rohana, J., Latinah, M., Thambidorai, C.R., Kaur, B.
    MyJurnal
    A retrospective study was conducted to evaluate the magnitude, clinical course and risk factors of cholestasis in surviving very low birth weight (VLBW) infants who received parenteral nutrition at the neonatal intensive care unit (NICU) of Hospital Universiti Kebangsaan Malaysia. Cholestasis was defined as direct hyperbilirubinaemia of >34 mmol/L. Between 1St July 2000 to 31St March 2001, 58 VLBW infants received parenteral nutrition (PN). Forty seven infants survived to discharge. Complete data was obtained from 43 (90.1%) infants. Thirteen (30.2%) of these infants developed cholestasis. The cholestasis persisted beyond the age of 6 weeks in 8 infants and they underwent hepato imino diacetic acid (HIDA) scan. The HIDA scan was reported as normal in 2 infants and inconclusive in 6 infants. Operative cholangiography. (OTC) was then performed in these infants and were all normal. The cholestasis finally resolved in all infants. Analysis of risk factors revealed that duration of assisted ventilation and PN and the presence of patent ductus arteriosus (PDA) had significant correlation with the development of cholestasis. These factors together with lower mean gestational age increased the likelihood of persistent cholestasis beyond 6 weeks of life in these infants. In conclusion cholestasis is common in VLBW infants who received parenteral nutrition. Although the clinical course seems benign, in a significant proportion of these infants it may persist longer and put them at increased risk of requiring invasive investigations.
    Matched MeSH terms: Ductus Arteriosus, Patent
  15. Koh GT, Ai Mokthar S, Hamzah A, Kaur J
    Ann Pediatr Cardiol, 2009 Jul;2(2):159-61.
    PMID: 20808631 DOI: 10.4103/0974-2069.58320
    We report a case of transcatheter closure of patent ductus arteriosus using the new Amplatzer duct occluder II in an adult patient with interrupted inferior vena cava with azygous continuation via the femoral artery approach.
    Matched MeSH terms: Ductus Arteriosus, Patent
  16. Wong A, Shahboden M, Pauzi W, Ibrahim W
    Pediatr Cardiol, 2007 Jan-Feb;28(1):74-5.
    PMID: 17318711 DOI: 10.1007/s00246-006-1398-9
    Matched MeSH terms: Ductus Arteriosus, Patent/classification; Ductus Arteriosus, Patent/diagnosis*; Ductus Arteriosus, Patent/pathology
  17. Abdelbasit MA, Alwi M, Kandavello G, Che Mood M, Samion H, Hijazi ZM
    Catheter Cardiovasc Interv, 2015 Jul;86(1):94-9.
    PMID: 25675888 DOI: 10.1002/ccd.25878
    OBJECTIVES: To evaluate the feasibility, safety, and efficacy of the Occlutech® PDA occluder for closure of patent ductus arteriosus (PDA).

    BACKGROUND: The Occlutech® PDA occluder is novel, self-shaping Nitinol wire device with PET (polyethylene terephthalate) patches integrated into the shank of the device to assure a better obturation of the ductus. The Occlutech® PDA occluder has undergone two design modifications.

    METHODS: A prospective, non-randomized pilot study was started in November 2011. Thirty-three patients were included until April 2013. Patients weighing <6 kg or those with associated cardiac anomalies that required surgery were excluded. All patients were followed up by transthoracic echocardiography at 24 hr, 30 days, 90 days, 180 days, and 360 days after implantation. Residual shunt, left pulmonary artery (LPA) and descending aortic velocities were among the parameters assessed. All occluders were delivered via 6-8 F long sheaths and PDA closures were performed following standard techniques.

    RESULTS: Thirty three patients (20 female/13 male), with a median age of 2 years (6 month to 38 years), and median weight of 9.3 kg (6-69.2 kg) were included. The narrowest median PDA diameter was 3mm (1.8-5.8 mm). All the 33 patients were closed successfully using Occlutech ductal occluder, 16 patients (48.4%) had immediate and complete closure on angiography. Within 24 hr, color Doppler revealed complete closure in 27patients (81.8%), 32patients (97%) at 30 days, and in 100% of patients at 90 days. All patients with a large PDA had immediate residual shunt which was closed at the 90-day follow-up. There was no device embolization, hemolysis, or obstruction to the LPA or descending aorta.

    CONCLUSION: The new Occlutech® PDA is safe and effective. In patients with a large PDA complete closure tended to take longer time.

    Matched MeSH terms: Ductus Arteriosus, Patent/diagnosis; Ductus Arteriosus, Patent/surgery*
  18. Alwi M, Choo KK, Radzi NA, Samion H, Pau KK, Hew CC
    J. Thorac. Cardiovasc. Surg., 2011 Jun;141(6):1355-61.
    PMID: 21227471 DOI: 10.1016/j.jtcvs.2010.08.085
    Objectives: Our objective was to determine the feasibility and early to medium-term outcome of stenting the patent ductus arteriosus at the time of radiofrequency valvotomy in the subgroup of patients with pulmonary atresia with intact ventricular septum and intermediate right ventricle.
    Background: Stenting of the patent ductus arteriosus and radiofrequency valvotomy have been proposed as the initial intervention for patients with intermediate right ventricle inasmuch as the sustainability for biventricular circulation or 1½-ventricle repair is unclear in the early period.
    Methods: Between January 2001 and April 2009, of 143 patients with pulmonary atresia and intact ventricular septum, 37 who had bipartite right ventricle underwent radiofrequency valvotomy and stenting of the patent ductus arteriosus as the initial procedure. The mean tricuspid valve z-score was -3.8 ± 2.2 and the mean tricuspid valve/mitral valve ratio was 0.62 ± 0.16.
    Results: Median age was 10 days (3-65 days) and median weight 3.1 kg (2.4-4.9 kg). There was no procedural mortality. Acute stent thrombosis developed in 1 patient and necessitated emergency systemic-pulmonary shunt. There were 2 early in-hospital deaths owing to low cardiac output syndrome. One late death occurred owing to right ventricular failure after the operation. Survival after the initial procedure was 94% at 6 months and 91% at 5 years. At a median follow-up of 4 years (6 months to 8 years), 17 (48%) attained biventricular circulation with or without other interventions and 9 (26%) achieved 1½-ventricle repair. The freedom from reintervention was 80%, 68%, 58%, and 40% at 1, 2, 3, and 4 years, respectively.
    Conclusions: Concomitant stenting of the patent ductus arteriosus at the time of radiofrequency valvotomy in patients with pulmonary atresia with intact ventricular septum and intermediate right ventricle is feasible and safe with encouraging medium-term outcome.
    Matched MeSH terms: Ductus Arteriosus, Patent/complications; Ductus Arteriosus, Patent/mortality; Ductus Arteriosus, Patent/physiopathology; Ductus Arteriosus, Patent/therapy*; Ductus Arteriosus, Patent/ultrasonography
  19. Bilkis AA, Alwi M, Hasri S, Haifa AL, Geetha K, Rehman MA, et al.
    J Am Coll Cardiol, 2001 Jan;37(1):258-61.
    PMID: 11153748 DOI: 10.1016/s0735-1097(00)01094-9
    Objectives: The aim of the study was to assess the safety and efficacy of the Amplatzer ductal occluder (ADO) in transcatheter occlusion of patent ductus arteriosus (PDA).
    Background: Transcatheter closure of small to moderate sized PDAs is an established procedure. The ADO is a self-expandable device with a number of salutary features, notably its retrievability, ease of delivery via small 5F to 7F catheters and a range of sizes suitable even for the larger PDAs.
    Methods: Between November 1997 and August 1999, the ADO was successfully implanted in 205 of 209 patients with PDA. The inclusion criteria for this device occlusion method were patients with clinical and echocardiographic features of moderate to large PDA, weighing > or =3.5 kg as well as asymptomatic adolescents and adults with PDA measuring > or =5.0 mm on two-dimensional (2D) echocardiogram. Occlusion was achieved via the antegrade venous approach. Follow-up evaluations were performed with 2D echocardiogram, color-flow mapping and Doppler measurement of the descending aorta and left pulmonary artery velocity at 24 h and 1, 3, 6 and 12 months after implantation.
    Results: Two hundred and five patients had successful PDA occlusion using this device. The patients were between two months and 50 years (median 1.9) and weighed between 3.4 kg and 63.2 (median 8.4). Infants made up 26% of the total patients. The PDA measured from 1.8 to 12.5 mm (mean 4.9) at the narrowest diameter. Forty-four percent of patients achieved immediate complete occlusion. On color Doppler the closure rates at 24 h and 1 month after implant were 66% and 97%, respectively. At 6 and 12 months all except one patient attained complete occlusion. Device embolization occurred in three patients; in two this was spontaneous, and in the other it was due to catheter manipulation during postimplant hemodynamic measurement. Mild aortic narrowing was seen in an infant.
    Conclusions: Patent ductus arteriosus occlusion using ADO is safe and efficacious. It is particularly useful in symptomatic infants and small children with relatively large PDA. Embolization can be minimized by selection of appropriate sized devices, and caution should be exercised in infants <5 kg.
    Matched MeSH terms: Ductus Arteriosus, Patent/radiography; Ductus Arteriosus, Patent/therapy*
  20. Zanjani KS, Wong AR, Sadiq M, Weber HS, Cutler NG
    Congenit Heart Dis, 2010 Sep-Oct;5(5):439-43.
    PMID: 21087429 DOI: 10.1111/j.1747-0803.2010.00448.x
    Objectives: There is little evidence in the medical literature about safety of PDA device closure and its effects on aortic root diameter in Marfan patients. We reported on nine Marfan patients whose ducts were occluded by coil or Amplatzer Duct Occluder.
    Patients and interventions: Two patients had aneurismal type E ducts which were closed by a single coil, respectively. The others had conical ducts for which even Amplatzer occluder, stiff, or double coils were used.
    Results: No untoward consequence was found during a median follow up period of 18.5 months (range 3 months to 6.33 years). Two patients had small residual shunts. The observed change in the mean ratio of aortic root diameter to its estimated value was statistically insignificant in seven patients who had complete data on their aortic root diameter before PDA closure and during the follow up.
    Conclusions: We concluded that PDA device closure in Marfan patients is safe. Risk of residual shunt is higher even after closure of small ducts.
    Matched MeSH terms: Ductus Arteriosus, Patent/complications; Ductus Arteriosus, Patent/therapy*; Ductus Arteriosus, Patent/ultrasonography
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