Interventional stent implantation in a child with patent ductus venosus and pulmonary hypertension

Abstract

To the best of our knowledge, this represents the first report of successful interventional stent occlusion of a patent ductus venosus associated with severe pulmonary hypertension. The future will tell whether this intervention is curative or represents a bridging procedure for subsequent liver transplantation.

Pulmonary Hypertension in Patients With Congenital Portosystemic Venous Shunt: A Previously Unrecognized Association

“…To the best of our knowledge, only a few patients with CPSVS have so far been reported to be associated with PAH, 3,16-21 and 4 of them developed PAH during childhood. 3,17,19,21 We herein describe a follow-up evaluation of 9 patients with CPSVS. We determined that PAH is 1 of the major complications of CPSVS.…”

A neonatal case of thoracoabdominal duplication associated with right congenital diaphragmatic hernia, absent inferior vena cava, and congenital portoazygous shunt: etiopathogenesis and surgical management

“…Pulmonary hypertension in this case was possibly secondary to the patient's portosystemic shunt. Portosystemic shunting, even with the absence of portal hypertension, could cause severe pulmonary hypertension [11][12][13]. It has been proposed that the vasoactive substances that are normally metabolized, or detoxified, by the liver are bypassed directly to the lung in their active form and thus cause pulmonary hypertension in such cases [13].…”

Transvenous Embolization of Patent Ductus Venosus in Two Adult Cases

“…With occlusion of the shunt, the portal venous pressure usually increases within several days. Since surgical management of patent DV can be quite problematic 4) , several percutaneous techniques have been used to treat the associated portosystemic shunt [10][11][12][13][14][21][22][23] , including placement of steel coils, a detachable balloon, a handmade Z stent covered with a graft, a reduction stent to decrease shunt volume and embolic materials such as autologous thrombin, cyanoacrylate, fibrin glue, and EO. There are three reports on transcatheter procedures for the treatment of patients with patent DV.…”

“…To our knowledge, only three reports of transvenous embolization in patients with this condition have been published [10][11][12] . We have experienced two adult patients with large caliber patent DV and compensated liver cirrhosis.…”

“…Large caliber patent DV is a rare congenital anomaly, and depending on the shunt ratio and decreased tolerance to ammonia [3][4][5][6][7][8][9][10][11][12] , and patients may suffer symptoms of portosystemic encephalopathy.…”