Abstract 10972: Transthoracic Echocardiography-guided Percutaneous Patent Ductus Arteriosus Occlusion: A New Strategy For Interventional Treatment

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Xiang-Bin Pan ◽  
Wen-Bin Ouyang ◽  
Shou-Zheng Wang ◽  
Yao Liu ◽  
Da-Wei Zhang ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Patent Ductus Arteriosus ◽  
Transthoracic Echocardiography ◽  
Guide Wire ◽  
Ductus Arteriosus ◽  
Main Pulmonary Artery ◽  
Interventional Treatment ◽  
Residual Shunt ◽  
Patent Ductus

Objectives: This prospective single center study investigated the safety and efficacy of percutaneous patent ductus arteriosus (PDA) occlusion using the Amplatzer Duct Occluder II (ADO II) under only guidance of transthoracic echocardiography, which avoids the radiation and contrast agents of traditional PDA occlusion. Methods: From June 2013 to February 2015, 54 consecutive PDA patients (age, 4.6 ± 2.9 years; weight, 18.5 ± 7.5 kg; PDA narrowest diameter, 3.3 ± 1.1 mm) underwent transthoracic echocardiography guided PDA occlusion through the femoral artery. Outpatient follow-up was conducted at 1, 3, and 6 months, and yearly. Results: Echocardiography-guided percutaneous PDA occlusion was successfully performed in 53 patients. The procedure was converted to minimally invasive transthoracic occlusion in one patient due to failure of delivery catheter passage through tortuous PDA. Mean procedure duration was 25.5 ± 7.4 minutes; ADO II diameter averaged 4.7 ± 0.9 mm; 8 cases showed traces of residual shunt immediately after operation; and mean hospital stay was 3.4 ± 0.7 days. There was no occluder migration, hemolysis or pericardial effusion at mean 10.2±4.9 months follow-up. Conclusions: Percutaneous PDA occlusion under only guidance of transthoracic echocardiography appears safe and effective while avoiding radiation and contrast agent use. Legends: A) A suprasternal view showed the tip of pigtail catheter (arrow) faced the aortic end of the PDA. B) The left parasternal long axis view of the pulmonary artery showed that the guide wire (arrow) was located within the main pulmonary artery. C) The release of the occluder at the pulmonary side (arrow). D) The occluder was completely released (arrows point to each side of the occluder). PDA, patent ductus arteriosus; DAO, descending aorta; PA, pulmonary artery; AO, ascending aorta.

A Case of Main Pulmonary Artery Aneurysm Associated with Patent Ductus Arteriosus

1989 ◽  
Vol 19 (2) ◽  
pp. 343
Author(s):  
Hong Lyeol Lee ◽  
Myong Ki Hong ◽  
Kyung Kwon Paik ◽  
Seung Jae Tahk ◽  
Woong Ku Lee ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Patent Ductus Arteriosus ◽  
Ductus Arteriosus ◽  
Main Pulmonary Artery ◽  
Artery Aneurysm ◽  
Pulmonary Artery Aneurysm ◽  
Patent Ductus

scholarly journals Pulmonary Artery and Pulmonic Valve Vegetations in a Young Pregnant Filipino with Patent Ductus Arteriosus

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Valerie R. Ramiro ◽  
Jezreel L. Taquiso ◽  
Stephanie Martha O. Obillos ◽  
Charlene F. Agustin ◽  
Jose Donato A. Magno ◽  
...  
Keyword(s):  
Risk Factor ◽  
Pulmonary Artery ◽  
Patent Ductus Arteriosus ◽  
Ductus Arteriosus ◽  
Response To Therapy ◽  
Pulmonic Valve ◽  
History Of ◽  
Previously Treated ◽  
Patent Ductus

Background. Infective endocarditis (IE) involving the pulmonic valve and/or the pulmonary artery is rare. An unrepaired patent ductus arteriosus (PDA) is a risk factor for IE. A previous IE is also a risk factor that predisposes to IE recurrence. Discriminating between IE recurrence and a persistence of a vegetation from a previously treated IE can be difficult. We present the case of a 19-year-old primigravid with an unrepaired PDA and a history of IE treated 7 years prior, with positive blood cultures and vegetations on the pulmonic valve and pulmonary artery seen on transthoracic echocardiogram (TTE). Methods and Results. On TTE, a small-sized PDA with a Qp : Qs of 1.18 and vegetations on the pulmonic valve and pulmonary artery were documented. Despite the paucity of symptoms, she was empirically treated as culture-negative IE and given 2 weeks of ceftriaxone. Repeat TTE done after 2 weeks only showed a slight decrease in the vegetation size. Due to the paucity of symptoms of infection, lack of growth of the vegetation, and absence of embolic events, the vegetations were deemed to be persistent remnants from the previous IE rather than a recurrent IE. She was advised surgical PDA closure and harvest of vegetations after delivery, but the patient did not consent. The rest of her perinatal course was uneventful. Conclusion. Persistence of vegetations despite successful medical treatment occurs in some cases and has not been reported to be associated with increased morbidity. Therefore, a follow-up of IE after treatment should be guided by the clinical course and response to therapy as well as the echocardiographic morphology of vegetations over time.

scholarly journals Transcatheter closure of patent ductus arteriosus using duct occluder: an eleven-year experience from a single tertiary cardiac center

2019 ◽  
Vol 7 (8) ◽  
pp. 2894
Author(s):  
Achyut Sarkar ◽  
Neha Rani ◽  
Prashant Kumar ◽  
Shyam Sundar Chaudhary ◽  
Suman Chatterjee
Keyword(s):  
Patent Ductus Arteriosus ◽  
Transcatheter Closure ◽  
Postgraduate Medical Education ◽  
Ductus Arteriosus ◽  
Volume Overload ◽  
Residual Shunt ◽  
Term Outcome ◽  
Procedural Success ◽  
Patent Ductus

Background: Patent Ductus Arteriosus (PDA) is a common congenital disorder. As an isolated lesion, PDA constitutes 6 to 11% of all congenital heart disease. PDA needs closure to eliminate pulmonary over circulation leading to volume overload of left ventricle, pulmonary vascular obstructed disease.Methods: This retrospective study was carried out in pediatric cardiology unit of Institute of Postgraduate Medical Education and Research, Kolkata from September 2005 to August 2016, which included 503 patients.Results: Device closure was attempted in 492 patient’s Procedural success was achieved in 85% cases on table, in who check aortogram revealed complete closure of PDA. In 15% cases, residual shunt was present. In 12% of cases, residual shunt disappeared during follow-up echocardiogram over 6-month follow-up. In 3% cases, small shunt remained at 6-month and 1-year follow up.Conclusion: Transcatheter closure of PDA by duct occluder is safe and effective with good mid-term outcome. The optimum assessment of ductul size and anatomy is crucial for optimum device size, which prevents residual shunt, device embolization and protrusion.

scholarly journals A Rare Complication of Patent Ductus Arteriosus Ligation: Inadvertent Ligation of the Left Pulmonary Artery

2017 ◽  
Vol 20 (6) ◽  
pp. 266 ◽  
Author(s):  
Semiha Terlemez ◽  
Onur Işık ◽  
Suzan Şahin ◽  
Abdullah Barış Akcan ◽  
Münevver Kaynak Türkmen
Keyword(s):  
Pulmonary Artery ◽  
Patent Ductus Arteriosus ◽  
Surgical Complication ◽  
Rare Complication ◽  
Ductus Arteriosus ◽  
Left Pulmonary Artery ◽  
Pda Ligation ◽  
Reconstruction Operation ◽  
Patent Ductus

Background: The inadvertent ligation of the left pulmonary artery (LPA) is a rarely seen surgical complication that has been presented in the literature in a limited number of cases after patent ductus arteriosus (PDA) ligation surgery. Case Report: A PDA closure operation was performed on our patient, a 28-week-old preterm. In the postoperative follow-up, we identified on echocardiography taken on the same postoperative day that the ductus space was still present. On CT angiography, we determined that not only was the ductus space still continuing, but, in addition, ligation of the LPA had been performed inadvertently. An LPA reconstruction operation was performed on the patient 46 days after the first operation. However, owing to severe tissue damage in LPA, LPA reperfusion did not occur in the postoperative period. Conclusion: Although inadvertent ligation of the left pulmonary artery during PDA ligation surgery is rarely seen in patients who have undergone closure surgery, this complication should be kept in mind in the postoperative follow-up period. Patient findings such as physical examination, lung angiography and postoperative echocardiography should be assessed with this in mind. 

scholarly journals Transcatheter Closure of Patent Ductus Arteriosus in Elderly Patients: Initial and One-Year Follow-Up Results—Do We Have the Proper Device?

2020 ◽  
Vol 2020 ◽  
pp. 1-8 ◽  
Author(s):  
Michal Galeczka ◽  
Malgorzata Szkutnik ◽  
Jacek Bialkowski ◽  
Sebastian Smerdzinski ◽  
Mateusz Knop ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Patent Ductus Arteriosus ◽  
Transcatheter Closure ◽  
Nyha Class ◽  
Ductus Arteriosus ◽  
Wire Mesh ◽  
Residual Shunt ◽  
One Year ◽  
Patent Ductus

Objectives. Patent ductus arteriosus (PDA) in elderly patients is an uncommon anomaly, and the duct itself is often calcified and fragile; therefore, transcatheter closure is more difficult. The aim is to analyse periprocedural and one-year follow-up results of transcatheter closure of PDA in such patients. Methods and results. Retrospective analysis of 33 elective patients aged ≥55 years (median 63; 56–85; 29 women), in whom PDA was closed percutaneously between 2002 and 2018 in two tertiary centres. All but three patients were symptomatic, with most in NYHA II (n = 14) and III (n = 11) class; pulmonary hypertension (n = 22), arterial hypertension (n = 22), duct calcifications (n = 17), atrial fibrillation (n = 15), significant mitral regurgitation (n = 5), and decompensated renal failure (n = 2) were observed. Different devices were applied depending on PDA morphology; nitinol wire mesh occluders with symmetrical articulating discs have been the most used in recent years (n = 11). Follow-up was conducted at an outpatient clinic (28/33 patients). The procedure was successful in all patients. There was one embolisation, followed by implantation of a larger device. No major complications were noted. A small residual shunt was present in echocardiography in one patient after one year. NYHA class improved in all but two patients (with multiple comorbidities). Conclusions. Transcatheter PDA closure in elderly patients is safe and efficient with a high complete closure rate and few complications. Amplatzer duct occluder type II is an attractive device in such patients.

Branch Pulmonary Artery Jailing During Patent Ductus Arteriosus Stenting: Recruitment and Immediate Outcomes

2021 ◽  
Vol 12 (3) ◽  
pp. 320-330
Author(s):  
Sudesh Prabhu ◽  
Abhijit Joshi ◽  
Siddhant Mehra ◽  
Riyan Shetty ◽  
Keshava Murthy ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Patent Ductus Arteriosus ◽  
Ductus Arteriosus ◽  
Pulmonary Arteries ◽  
Branch Pulmonary Artery ◽  
Icu Stay ◽  
Ventilation Duration ◽  
Stenting Procedure ◽  
Patent Ductus

Background: Branch pulmonary artery (PA) occlusion during patent ductus arteriosus (PDA) stenting procedure is the main reason why branch PA origin stenosis was considered as a contraindication for PDA stenting. This study was designed to assess the incidence of branch PA jailing during PDA stenting for cyanotics with duct-dependent pulmonary circulation and its immediate outcome. Methods: All the completed PDA stenting patients in our hospital between April 2017 and June 2019 were retrospectively analyzed for branch PA jailing and its outcome. Results: Of 63 completed PDA stenting, there was branch PA jailing in 13 (20.6%) patients, all successfully recruited either by strut dilatation or by surgery. The median duration of ventilation was 16 (interquartile range [IQR]: 8-22) hours for jailed patients and 17.5 (IQR: 5.25-34.25) hours for nonjailed patients ( P = .978). Median intensive care unit [ICU] stay was 69 (IQR: 47.75-96) hours for jailed patients and 79.5 (IQR: 66.75-135.25) hours for nonjailed patients ( P = .394). Procedural mortality was 1 (7.6%) for jailed patients and 3 (6%) for nonjailed patients. Since all the jailed pulmonary arteries were recruited, there was proportionate growth of branch PA till the most recent follow-up. Conclusion: Jailing of branch PA does not increase the ventilation duration, ICU stay, or mortality risk if recruited immediately. Proportionate growth of branch PAs can be achieved in spite of jailing, if addressed aggressively. Branch PA stenosis should not be considered as a contraindication for PDA stenting.

Echocardiographic diagnosis of a mycotic aneurysm of the main pulmonary artery and patent ductus arteriosus

1992 ◽  
Vol 123 (6) ◽  
pp. 1707-1709 ◽  
Author(s):  
Jesus Vargas-Barron ◽  
Lucrecia Avila-Rosales ◽  
Angel Romero-Cardenas ◽  
Maria Rijlaarsdam ◽  
Candace Keirns ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Patent Ductus Arteriosus ◽  
Mycotic Aneurysm ◽  
Ductus Arteriosus ◽  
Main Pulmonary Artery ◽  
Patent Ductus
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