Successful Closure of a Patent Ductus Arteriosus Using an Aortic Stent Graft

Fujita, Kosuke; Sakurai, Toshihiko; Kitayama, Hitoshi; Nakamoto, Susumu; Kaneda, Tomoya; Nishino, Tomoya; Yukami, Shintaro

doi:10.5761/atcs.cr.10.01656

Cited by 11 publications

(10 citation statements)

References 11 publications

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“…2 a Aortography before a stent graft implantation demonstrated that most contrast agents ran into the pulmonary artery (PA) through the ductus. b Postoperative aortography showed no residual shunt PDA tissue during transcatheter procedures may cause unfavorable complications, such as dissection, perforation and device migration [3]. Therefore, non-touch exclusion by TEVAR may reduce procedure-related complications observed with other endovascular devices.…”

Section: Discussionmentioning

confidence: 98%

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Thoracic endovascular aortic repair for patent ductus arteriosus in an elderly patient with congestive heart failure

Kato

Nakai

Tokunaga

et al. 2014

Gen Thorac Cardiovasc Surg

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In elderly patients, open surgery for patent ductus arteriosus (PDA) is more difficult than that in children and often requires a cardiopulmonary bypass. We report the case of a 67-year-old patient with a PDA that was successfully treated with thoracic endovascular aortic repair (TEVAR). The patient was diagnosed with congestive heart failure (ejection fraction, 36 %) and PDA (9.7 mm in diameter). TEVAR was successfully performed to exclude the PDA. After TEVAR, the patient's heart failure was well controlled by diuretics. TEVAR may be a good alternative to open surgery.

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Section: Discussionmentioning

confidence: 98%

“…Because TEVAR devices are originally designed for TAA treatment, TEVAR can be safely applied to aneurysmal PDA. Several authors have already reported successful treatment of aneurysmal PDA by TEVAR [3]. Therefore, TEVAR may become the first choice of treatment for aneurysmal PDA.…”

Section: Discussionmentioning

confidence: 98%

Thoracic endovascular aortic repair for patent ductus arteriosus in an elderly patient with congestive heart failure

Kato

Nakai

Tokunaga

et al. 2014

Gen Thorac Cardiovasc Surg

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“…Several recent studies described patients treated by arterial duct closure with a stent graft. [8][9][10] In the future, the low profile of a stent graft delivery system may lead to increase in the number of patients undergoing TEVAR for PDA in adults. On the other hand, concerns have also been expressed over TEVAR.…”

Section: Discussionmentioning

confidence: 99%

A Case of Patent Ductus Arteriosus in an Elderly Patient Treated by Thoracic Endovascular Aortic Repair

Orimoto

Ishibashi

Sugimoto

et al. 2016

Annals of Vascular Diseases

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The patient described herein was a 75-year-old female. Echocardiography showed patent ductus arteriosus (PDA). Heart failure symptoms gradually appeared, and she was referred to our department for treatment. Contrast-enhanced computed tomography (CT) revealed a tubular structure communicating between the aortic arch and pulmonary artery trunk, suggesting adult PDA. Thoracic endovascular aortic repair (TEVAR) was performed to close PDA. Completion angiography confirmed the disappearance of PDA. Post-TEVAR CT revealed no endoleak. The patient was discharged from the hospital on the 11th day after surgery. TEVAR is more useful and less invasive for adult PDA than conventional open surgery. Keywords: patent ductus arteriosus (PDA), thoracic endovascular aortic repair (TEVAR)thoracic endovascular aortic repair (TEVAR) for PDA in an elderly patient. Case ReportA 75-year-old female consulted a local clinic with cold symptoms. Tachycardia and cardiac murmurs were detected, and echocardiography showed PDA. Heart failure symptoms gradually became exacerbated, and she was referred to our hospital. Her height and body weight were 149 cm and 52.5 kg, respectively. Continuous murmurs were heard in the thoracic region. Chest X-ray revealed a protrusion in the left second arch (pulmonary artery trunk) and the enhancement of a pulmonary vascular shadow. The cardio-thoracic ratio (CTR) was 66%. Electrocardiography did not show any abnormal findings. Echocardiography revealed PDA with a diameter of 8 mm and high shunt flow (Vmax: 600 cm/sec). Dilatation of the left ventricle and atrium suggesting left heart loading was observed. Right heart catheterization revealed a leftto-right shunt with an increase in pulmonary arterial pressure. The pulmonary to systemic blood flow ratio (Qp/Qs) was 2.1. On saturation, O2 step-up of the pulmonary artery was observed. Contrast-enhanced computed tomography (CT) revealed an arterial duct communicating between the aortic arch and pulmonary artery that measured 14 mm in diameter (Fig. 1a). The pulmonary artery trunk measured 55 mm and showed marked dilatation involving the left and right pulmonary arteries (Fig. 1b). The distance between the left subclavian artery and arterial duct was 20 mm. The aortic diameter at a tributary of the subclavian artery was 27 mm, and that of the thoracic descending aorta was 25 mm (Fig. 2). Arterial-duct closure by the placement of a stent graft at zone 3 was considered possible. Surgery was performed under general anesthesia. A pigtail catheter was inserted from the left brachial artery, and digital subtraction angiography (DSA) was performed. Blood flow from the aorta to the pulmonary artery was clearly confirmed. TEVAR using CTAG 31 mm-15 cm

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“…Because we found no aneurysmal change, there was no necessity for invasive procedures such as intra-aortic patch repair, total arch replacement with open-stent grafting, or thoracic endovascular aortic repair (TEVAR). 2) Only for PDA, TEVAR concomitant with axilloaxillary bypass would be a useful option. To reduce the likelihood of thromboembolic events due to manipulation of an occlusion balloon through the ductus, the procedure was performed under hypothermic circulatory arrest.…”

Section: Discussionmentioning

confidence: 99%

Simultaneous Surgery for Patent Ductus Arteriosus Associated with Papillary Fibroelastoma

Morishita

Tomioka

Katahira

et al. 2014

ATCS

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We describe a case of patent ductus arteriosus (PDA) in a 76-year-old woman with a history of stroke, atrial fibrillation, and chronic obstructive pulmonary disease. Cranial diffusion-weighted imaging (DWI) performed for preoperative assessment showed a hyperintense lesion in the left cerebellum. Preoperative transesophageal echocardiography (TEE) demonstrated two highly mobile masses approximately 5 mm in diameter adherent to the left and non-coronary cusps of the aortic valve. We performed transpulmonary patch closure of PDA under hypothermic circulatory arrest. Subsequently, two frond-like masses were completely shaved off the cusps, preserving the native aortic leaflets. Pathological examination confirmed the diagnosis of papillary fibroelastoma (PFE). To our knowledge, this is the first report of PDA associated with PFE. Perioperative use of TEE is an effective tool for management of cardiovascular patients with suspected cardiogenic embolism.

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Successful Closure of a Patent Ductus Arteriosus Using an Aortic Stent Graft

Cited by 11 publications

References 11 publications

Thoracic endovascular aortic repair for patent ductus arteriosus in an elderly patient with congestive heart failure

Thoracic endovascular aortic repair for patent ductus arteriosus in an elderly patient with congestive heart failure

A Case of Patent Ductus Arteriosus in an Elderly Patient Treated by Thoracic Endovascular Aortic Repair

Simultaneous Surgery for Patent Ductus Arteriosus Associated with Papillary Fibroelastoma

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