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

<b>Aim:</b> 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.<b>Methods:</b> Retrospective review of children in whom APO was utilized for defects other than PDA between January 2022 and June 2023.<b>Results:</b> 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.<b>Conclusion:</b> 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.