Transcatheter coil closure of large patent ductus arteriosus with 0.052-inch Gianturco coils using myocardial biopsy forceps in a 70-year-old woman

Transcatheter coil embolization for patent ductus arteriosus in the elderly: report of a case and review of the published work

Patent ductus arteriosus is the third most common congenital cardiovascular anomaly, however, it is rarely found in the elderly. We describe a case of patent ductus arteriosus in a 72-year-old woman in whom patent ductus arteriosus was successfully managed by transcatheter coil embolization. The patient had been diagnosed with a heart murmur for the first time 1 year earlier at the age of 71. She was asymptomatic but a continuous murmur was heard. Cardiac catheterization revealed migration of a catheter from the main pulmonary artery into the descending aorta through a patent ductus arteriosus and a significant step-up of oxygen saturation in the main pulmonary artery with a pulmonary-to-systemic flow ratio of 1.68. Aortograms demonstrated a communication between the aorta and the pulmonary artery through a patent ductus arteriosus with a minimal diameter of 3.7 mm. Transcatheter coil embolization of the patent ductus arteriosus was successfully carried out with two 0.052-inch-diameter Gianturco coils. Doppler echocardiographic study confirmed no residual shunt in the main pulmonary artery after the procedure. Non-surgical transcatheter occlusion using coil embolization appears to be an effective and minimally invasive technique for treatment of patent ductus arteriosus in the elderly.