Off-label uses of the Amplatzer Piccolo Occluder in children with congenital and acquired heart diseases.

The Amplatzer Piccolo Occluder (APO) is approved for patent ductus arteriosus (PDA) occlusion in infants weighing >700 g but could offer versatility to treat other lesions. Retrospective review of children in whom APO was utilized for defects other than PDA between January 2022 and June 2023. The APO was used in nine patients; three for ventricular septal defects, four with coronary fistulas, one for a ventricular pseudoaneurysm and one where APO deployed within a fenestration of a previously placed Amplatzer Septal Occluder. All nine patients had successful occlusions without complications. The APO is a versatile device that can be used to treat various small diameter lesions in children besides the PDA for which it is currently approved for.