Missed case of fever of unknown origin during COVID-19 pandemic: patent ductus arteriosus endarteritis

A 40-year-old woman presented with fever of unknown origin (FUO) for 2 months. Without a definitive diagnosis and having received multiple empirical antibiotics from outside without relief, she was referred to our centre. Cardiac auscultation was remarkable for a grade 3/6 continuous murmur in the upper left sternal border. Echocardiogram revealed a patent ductus arteriosus (PDA) and a 5×7 mm mobile vegetation at the pulmonary artery bifurcation. Blood culture grew Streptococcus mutans. Embolisation of the vegetation to the pulmonary circulation occurred after the start of intravenous antibiotics resulting in fever relapse. Antibiotics were continued for 6 weeks and the fever settled. She underwent device closure of PDA after 12 weeks and is currently doing fine. Infective endocarditis/endarteritis is an important differential in a patient of FUO. A thorough clinical examination is important in every case of FUO, gives an important lead into diagnosis and guides appropriate investigations to confirm it.

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Intravascular ultrasonography-guided measurement and transcatheter closure of highly calcified patent ductus arteriosus in an older adult

Cardiology in the Young ◽

10.1017/s1047951121002250 ◽

2021 ◽

pp. 1-3

Author(s):

Yoko Kawai ◽

Takeshi Nakamura ◽

Satoaki Matoba

Keyword(s):

Older Adults ◽

Patent Ductus Arteriosus ◽

Older Adult ◽

Transcatheter Closure ◽

Ductus Arteriosus ◽

Ct Images ◽

Device Closure ◽

Intravascular Ultrasonography ◽

Patent Ductus

Abstract In older adults with patent ductus arteriosus, CT is widely used for duct visualisation because angiography images can be inadequate for evaluation. We report the case of a 73-year-old woman with a highly calcified patent ductus arteriosus whose CT images were insufficient for accurate measurement. Intravascular ultrasonography is useful for sizing of and guiding device closure of the duct.

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Assessment of Left Ventricular dysfunction and its predictors following catheter guided Patent Ductus Arteriosus device closure

Indian Heart Journal ◽

10.1016/j.ihj.2020.11.121 ◽

2020 ◽

Vol 72 ◽

pp. S44

Author(s):

ABIMANYU UPPAL

Keyword(s):

Patent Ductus Arteriosus ◽

Left Ventricular Dysfunction ◽

Ventricular Dysfunction ◽

Ductus Arteriosus ◽

Left Ventricular ◽

Device Closure ◽

Patent Ductus

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Device closure of patent ductus arteriosus: analysis of cases in a Bangladeshi centre

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20202573 ◽

2020 ◽

Vol 7 (7) ◽

pp. 1481

Author(s):

Nurun N. Fatema ◽

Abul K. M. Razzaque

Keyword(s):

Patent Ductus Arteriosus ◽

Transcatheter Closure ◽

Ductus Arteriosus ◽

Age Groups ◽

Device Closure ◽

Catheterization Laboratory ◽

Congenital Rubella ◽

First Choice ◽

Associated Conditions ◽

Patent Ductus

Background: Transcatheter closure of Patent ductus arteriosus (PDA) has become the first-choice therapy for closure in patients of any age group. Authors reviewed the outcome of device closure in all age groups starting from neonate to adult.Methods: From December 2014 to December 2019, 440 cases underwent transcatheter closure in a catheterization laboratory of a tertiary level cardiac hospital. Selection criteria were isolated PDA or PDA with associated conditions which can be managed in the same setting by an intervention. Exclusion criteria were proven Eisenmenger syndrome. A retrospective review of outcome and complications were recorded from computerized data records.Results: Age of the patient varied from 10 days to 65 years. The median age was 3 years. Most of the patients were female (63%), weight varied from 1.8 kg to 75 kg. the median weight was 7.5 kg. Isolated PDA cases were 74.77 %. Among syndromes, congenital rubella syndrome was common (7.5%), followed by Down Syndrome (6.36%). The narrowest PDA diameter varied for 1.8 mm - 14 mm with a median of 5 mm. Among duct occluders, 8x6 mm CeraTM was the commonest one used in the study population. Complete occlusion was observed in 99.55% of cases.Conclusions: Transcatheter closure of PDA is considered safe and efficacious in all age groups. It is the gold standard now and replaced surgical option in most of the places.

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MANAGEMENT OF HYPERTENSIVE PDA

Pakistan Armed Forces Medical Journal ◽

10.51253/pafmj.v70isuppl-4.6003 ◽

2021 ◽

Vol 70 (Suppl-4) ◽

pp. S701-05

Author(s):

Khushal Khan Khattak ◽

Maad Ullah ◽

Abdul Malik Sheikh ◽

Asma Kanwal ◽

Sajid Ali Shah ◽

...

Keyword(s):

Pulmonary Hypertension ◽

Pulmonary Artery ◽

Patent Ductus Arteriosus ◽

Palliative Treatment ◽

Ductus Arteriosus ◽

Treatment Options ◽

Device Closure ◽

Surgical Ligation ◽

Percutaneous Catheter ◽

Patent Ductus

Objective: To determine different treatment options in patients of Patent Ductus Arteriosus with pulmonary hypertension beyond neonatal period. Study Design: Descriptive cross sectional study. Place and Duration of Study: This study was carried out in Pediatric Cardiology department of Rawalpindi Institute of Cardiology, from Jan 2017 to Jan 2019. Methodology: Patients having PDA with pulmonary hypertension were included in the study. Treatment options were divided into percutaneous catheter device closure, surgical ligation of patent ductus arteriosus and palliative treatment. Any adverse event during the procedure was documented. Stratification was done in regard to gender and age group. Post stratification chi square test was applied and p-value less than or equal to 0.05 was considered as significant. Results: Total number of patients included in the study were 37. Mean age (years) of patients (Mean ± SD) was 19.21 ± 8.76. Mean ± SD pulmonary artery pressure was 56.43 ± 11.55 mmHg. Percutaneous catheter device closure was successful in 24 (64.9%) patients, in 7 (18.9%) patients primary surgical PDA ligation was done, 3 (8.1%) patients were advised palliative treatment and in 3 (8.1%) patients adverse events occurred during percutaneous device closure and were thus referred for surgical ligation. Patent ductus Arteriosus Occlutech device was used in 18 (48.6%) patients, Occlutech VSD device was used in 7 (18.5%) patients and in 1 (2.7%) patient AGA duct occluder was used. Conclusion: In patients with patent ductus arteriosus and pulmonary artery hypertension, percutaneous catheter device closure is a safe and effective procedure.

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Transcatheter Patent Ductus Arteriosus (PDA) Device Closure

Case-Based Clinical Cardiology ◽

10.1007/978-1-4471-7496-7_65 ◽

2021 ◽

pp. 395-403

Author(s):

Ata Firouzi ◽

Zahra Hosseini

Keyword(s):

Patent Ductus Arteriosus ◽

Ductus Arteriosus ◽

Device Closure ◽

Patent Ductus

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Device Closure of Patent Ductus Arteriosus in Adults

Canadian Journal of Cardiology ◽

10.1016/j.cjca.2019.10.022 ◽

2020 ◽

Vol 36 (6) ◽

pp. 795-796

Author(s):

Michael L. O’Byrne ◽

Christopher L. Smith ◽

Matthew J. Gillespie

Keyword(s):

Patent Ductus Arteriosus ◽

Ductus Arteriosus ◽

Device Closure ◽

Patent Ductus

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New Minimally Invasive Technique of Perpulmonary Device Closure of Patent Ductus Arteriosus Through a Parasternal Approach

The Annals of Thoracic Surgery ◽

10.1016/j.athoracsur.2011.12.017 ◽

2012 ◽

Vol 93 (3) ◽

pp. 862-868 ◽

Cited By ~ 5

Author(s):

Li Hongxin ◽

Guo Wenbin ◽

Mei Zhu ◽

Fei Liang ◽

Wenlong Zhang ◽

...

Keyword(s):

Minimally Invasive ◽

Patent Ductus Arteriosus ◽

Ductus Arteriosus ◽

Minimally Invasive Technique ◽

Invasive Technique ◽

Device Closure ◽

Patent Ductus

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Percutaneous closure of a large patent ductus arteriosus in a preterm newborn weighing 1400 g without using arterial sheath: an innovative technique

Cardiology in the Young ◽

10.1017/s1047951117002475 ◽

2017 ◽

Vol 28 (3) ◽

pp. 494-497 ◽

Cited By ~ 1

Author(s):

Gaurav Garg ◽

Vishal Garg ◽

Amit Prakash

Keyword(s):

Patent Ductus Arteriosus ◽

Very Low Birth Weight ◽

Ductus Arteriosus ◽

Arterial Injury ◽

Percutaneous Closure ◽

Device Closure ◽

Low Birth Weight Infants ◽

Surgical Ligation ◽

Innovative Technique ◽

Patent Ductus

AbstractPercutaneous closure of patent ductus arteriosus is well established in infants weighing >5 kg, but data regarding outcome of preterm especially very low birth weight infants is minimal. Although surgical ligation of patent ductus arteriosus is the preferred and well-accepted modality of treatment after failure of drug therapy in preterm infants, it has also got its own demerits in such a small and fragile subset. Device closure in infants weighing <1.5 kg is rarely attempted because of high chances of complications, especially acute arterial injury due to the arterial sheath. We received a 1.4-kg ventilator-dependent infant for closure of large patent ductus arteriosus. Percutaneous closure of patent ductus arteriosus was done successfully and the infant was discharged on room air with a weight of 1.8 kg. We present here an innovative technique in which successful patent ductus arteriosus device closure was done in a 1.4-kg infant without using arterial sheath.

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