The Patent Ductus Arteriosus in Adults with Special Focus on Role of CT

The primary imaging modality for the diagnosis of patent ductus arteriosus (PDA) is echocardiography. However, CT may be the technique on which an incidental PDA is first recognized because of the increasing number of chest CT scans performed for a variety of causes. Identification of PDA on CT may lead to earlier closure using a PDA occluder device. Immediate identification of incidental PDA is important, but a high rate of missed diagnosis of PDA has been reported due to its small size and anatomic location. In addition, echocardiography may overlook the presence of even a large PDA due to decrease in the amount of shunting through the PDA caused by high pulmonary artery pressures. This review provides the basic CT anatomy and clinical perspective of PDA, and discusses the role of CT in the evaluation of PDA as well as methods to avoid overlooking a small PDA on CT.

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Trans-catheter closure of large PDA in adult patients with Amplatzer device: case series

Cardiology in the Young ◽

10.1017/s1047951121002602 ◽

2021 ◽

pp. 1-4

Author(s):

Zahra Khajali ◽

Ata Firouzi ◽

Homa Ghaderian ◽

Maryam Aliramezany

Keyword(s):

Ventricular Septal Defect ◽

Patent Ductus Arteriosus ◽

Septal Defect ◽

Ductus Arteriosus ◽

Diagnostic Methods ◽

Adult Patients ◽

Amplatzer Device ◽

Occluder Device ◽

Catheter Closure ◽

Patent Ductus

Abstract Ductus arteriosus is a physiological structure if not closed after birth, may lead to many complications. Today, trans-catheter closure of patent ductus arteriosus with Occluder devices is the preferred method. Surgical ligation is used only in certain cases such as large symptomatic patent ductus arteriosus in very small infants and premature babies; unfavourable structure of the duct or economic considerations. In this article, we described haemodynamic and morphological characteristics of five patients with large patent ductus arteriosus which were occluded with Amplatzer device. From 23 January, 2010 to 31 July, 2018, five patients referred to our clinic with large patent ductus arteriosus and pulmonary arterial hypertension for further evaluation. After assessing them with various diagnostic methods, we decided to close defect with ventricular septal defect Occluder device. Patients aged 21–44 years and one of them was male. Ductus closure was successfully done with ventricular septal defect Occluder device. Closure was successful for all of them but in one case, whose device was embolized to pulmonary artery after 24 hr and he underwent surgery. Trans-catheter closure of large patent ductus arteriosus in adult patients with pulmonary hypertension is feasible. Despite the fact that complications may occur even with the most experienced hands, the ‘double disk’ Amplatzer ventricular septal defect muscular Occluder could be advantageous in this setting.

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Modern treatment of patent ductus arteriosus – single center experience

Journal of Health Sciences ◽

10.17532/jhsci.2014.212 ◽

2014 ◽

Vol 4 (3) ◽

pp. 181-185

Author(s):

Senka Mesihović Dinarević ◽

Almira Kadic ◽

Zijo Begić ◽

Mirza Halimić ◽

Emina Vukas

Keyword(s):

Patent Ductus Arteriosus ◽

Transcatheter Closure ◽

Ductus Arteriosus ◽

Length Of Hospital Stay ◽

Single Center Experience ◽

Pediatric Clinic ◽

Occluder Device ◽

Length Of Hospitalization ◽

Selection Of ◽

Patent Ductus

Introduction: Transcatheter closure is a treatment choice for the most children with patent ductus arteriosus (PDA). The closure of the ductus is indicated in any child or adolescent with developed symptoms of significant L-R shunt. The aim of this article is to present our results in 5 years treatment of patients with PDA and their outcome. Methods: From 2009 to 2014, 30 patients underwent a transcatheter closure of PDA at Centre for Heart and Pediatric clinic of Clinical University Centre of Sarajevo. Aortic angiogram was performed to evaluate the size, position, and shape of the duct for selection of appropriate occluder device type and size. All procedures were performed by local team of cardiologists from the Department of Cardiology, Pediatric clinic, with invasive cardiologists team from Sweden and Austria. Echocardiography was repeated at intervals of 24 hours, then 1month, 3 months, and 1 year after the procedure to assess the outcome. Results: Thirty patients underwent transcatheter closure of PDA during the study period. PDA of ≤ 2.0 mm was present in 8 patients and they underwent PDA closure with coils, while 22 patients had PDA diameter ≥ 2 mm, and they were treated by Amplatzer duct occluder (ADO). Only in 2 (6.2%) patients complications have been observed. The length of hospital stay after the treatment was two to three days. Conclusion: Transcatheter closure of PDA is a modern, safe and efficient method that ensures a faster recovery of the patients, shortens the length of hospitalization.

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Comparison of the effect of two drugs paracetamol with intravenous ibuprofen in patent ductus arteriosus treatment

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20201741 ◽

2020 ◽

Vol 9 (5) ◽

pp. 690

Author(s):

Mehrdad Mirzarahimi ◽

Ramin Emamzadeghan ◽

Afsaneh Enteshari Moghaddam ◽

Narges Falsafi

Keyword(s):

Patent Ductus Arteriosus ◽

Ductus Arteriosus ◽

Alternative Therapy ◽

Cyclooxygenase Inhibitors ◽

Arterial Duct ◽

Intravenous Paracetamol ◽

Liver Parameters ◽

Intravenous Ibuprofen ◽

Patent Ductus

Background: Patent ductus arteriosus (PDA) is a common cause of morbidity and mortality among premature infants that affects more than 40% of them. PDA treatment includes medical and surgical treatment. Most drugs used to block PDA are cyclooxygenase inhibitors (ibuprofen and indomethacin). The role of paracetamol as an alternative therapy in PDA ligation has been considered in recent years due to the potential side effects of cyclooxygenase inhibitors.Methods: Patients in the first group were treated with intravenous paracetamol at a dose of 15 mg/kg every 6 hours for three days and the second group was treated with intravenous ibuprofen at a daily dose of 10 mg/kg daily and 5 mg/kg for the second and third days. At the end of the treatment period (day 3), they underwent echocardiography again. If the echocardiographic findings indicated no closure of the arterial duct, patients were treated with the aforementioned drug for another period and rechecked at the end of the third day, and at each stage required information was collected.Results: Arterial duct closure in paracetamol group was 96.7% and in ibuprofen group was 100%. The effects of both paracetamol and ibuprofen were similar in terms of renal parameters but in terms of effects on liver parameters. The effect of paracetamol on all liver parameters except aspartate transaminase (AST) was significant, but ibuprofen was able to affect only bilirubin among liver parameters and had no significant effect on both AST and alanine aminotransferase, parameters.Conclusions: Results showed that both paracetamol and ibuprofen are effective in treating of PDA and had similar impact.

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