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Souza GR, Barreto do Amaral A, Busch S, Villa Martignoni F. Natural History of a Disease: Patent Ductus Arteriosus Diagnosed on an Elderly Woman. Cureus 2023; 15:e49519. [PMID: 38156142 PMCID: PMC10753167 DOI: 10.7759/cureus.49519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2023] [Indexed: 12/30/2023] Open
Abstract
Patent ductus arteriosus (PDA) is a rare finding in adults. The ductus arteriosus (DA) is responsible for shunting blood from the pulmonary artery into the aorta bypassing the lungs in fetal life (the placenta is responsible for fetal oxygenated blood). Its closure happens after birth, once fetal circulation transitions to normal postnatal circulation and blood oxygenates in the lungs. If the DA does not close, the PDA may continue to shunt blood from the systemic (higher pressure) to the pulmonary (lower pressure) circulation causing remodeling of the left ventricle and eventually heart failure. A PDA is suspected when there is a systolic/diastolic murmur in the left sternal border; a transthoracic or transesophageal echocardiogram may visualize the shunt and measure the systemic/pulmonary shunt ratio. We described a case of an 84-year-old elderly woman who presented with an acute heart failure exacerbation as the first symptom of PDA and was found to have left ventricular hypertrophy, right ventricular hypertrophy, and pulmonary hypertension as the initial presentation.
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Affiliation(s)
| | | | - Sarah Busch
- Internal Medicine, University of Washington School of Medicine WWAMI, Lewistown, USA
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Shoji S, Kanazawa H, Yanagisawa R, Tanaka M, Fukuoka R, Akita K, Kimura M, Arai T, Kawakami T, Hayashida K, Yuasa S, Tsuruta H, Itabashi Y, Murata M, Nishiyama T, Kohno T, Maekawa Y, Fukuda K. Percutaneous Occlusion of Patent Ductus Arteriosus for an Elderly Patient With Refractory Congestive Heart Failure. Circ Heart Fail 2018; 11:e004764. [PMID: 29367269 DOI: 10.1161/circheartfailure.117.004764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Satoshi Shoji
- From the Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Hideaki Kanazawa
- From the Department of Cardiology, Keio University School of Medicine, Tokyo, Japan.
| | - Ryo Yanagisawa
- From the Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Makoto Tanaka
- From the Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Ryoma Fukuoka
- From the Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Keitaro Akita
- From the Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Mai Kimura
- From the Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Takahide Arai
- From the Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Takashi Kawakami
- From the Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Kentaro Hayashida
- From the Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Shinsuke Yuasa
- From the Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Hikaru Tsuruta
- From the Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Yuji Itabashi
- From the Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Mitsushige Murata
- From the Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Takahiko Nishiyama
- From the Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Takashi Kohno
- From the Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Yuichiro Maekawa
- From the Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Keiichi Fukuda
- From the Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
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Sumarokov AB, Bedimogova SS, Nekrutman EA, Epifanova ON, Veselova TN, Atanesyan RV, Blinova EV, Sakhnova TA, Korobkova IZ, Fateeva LV, Martynyuk TV. [A case of primary diagnosis of patent ductus arteriosus at the age of 75 years]. TERAPEVT ARKH 2017; 89:86-90. [PMID: 28514406 DOI: 10.17116/terarkh201789486-90] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The paper describes a case of primary diagnosis of functioning patent ductus arteriosus in a 75-year-old female patient.
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Affiliation(s)
- A B Sumarokov
- A.L. Myasnikov Institute of Clinical Cardiology, Russian Cardiology Research and Production Complex, Ministry of Health of the Russian Federation, Moscow
| | - S S Bedimogova
- A.L. Myasnikov Institute of Clinical Cardiology, Russian Cardiology Research and Production Complex, Ministry of Health of the Russian Federation, Moscow
| | - E A Nekrutman
- A.L. Myasnikov Institute of Clinical Cardiology, Russian Cardiology Research and Production Complex, Ministry of Health of the Russian Federation, Moscow
| | - O N Epifanova
- A.L. Myasnikov Institute of Clinical Cardiology, Russian Cardiology Research and Production Complex, Ministry of Health of the Russian Federation, Moscow
| | - T N Veselova
- A.L. Myasnikov Institute of Clinical Cardiology, Russian Cardiology Research and Production Complex, Ministry of Health of the Russian Federation, Moscow
| | - R V Atanesyan
- A.L. Myasnikov Institute of Clinical Cardiology, Russian Cardiology Research and Production Complex, Ministry of Health of the Russian Federation, Moscow
| | - E V Blinova
- A.L. Myasnikov Institute of Clinical Cardiology, Russian Cardiology Research and Production Complex, Ministry of Health of the Russian Federation, Moscow
| | - T A Sakhnova
- A.L. Myasnikov Institute of Clinical Cardiology, Russian Cardiology Research and Production Complex, Ministry of Health of the Russian Federation, Moscow
| | - I Z Korobkova
- A.L. Myasnikov Institute of Clinical Cardiology, Russian Cardiology Research and Production Complex, Ministry of Health of the Russian Federation, Moscow
| | - L V Fateeva
- A.L. Myasnikov Institute of Clinical Cardiology, Russian Cardiology Research and Production Complex, Ministry of Health of the Russian Federation, Moscow
| | - T V Martynyuk
- A.L. Myasnikov Institute of Clinical Cardiology, Russian Cardiology Research and Production Complex, Ministry of Health of the Russian Federation, Moscow
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Cho EH, Song J, Kang IS, Huh J, Lee SY, Choi EY, Kim SJ. Transcatheter closure of small ductus arteriosus with amplatzer vascular plug. KOREAN JOURNAL OF PEDIATRICS 2013; 56:396-400. [PMID: 24223601 PMCID: PMC3819676 DOI: 10.3345/kjp.2013.56.9.396] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Revised: 07/24/2013] [Accepted: 08/05/2013] [Indexed: 11/27/2022]
Abstract
PURPOSE The purpose of this study was to share our experience of transcatheter closure of small patent ductus arteriosus (PDA) by using an Amplatzer vascular plug (AVP). METHODS We reviewed the medical records of 20 patients who underwent transcatheter closure at Samsung Medical Center and Sejong General Hospital from January 2008 to August 2012. The size and shape of the PDAs were evaluated by performing angiograms, and the PDA size and the AVP devices size were compared. RESULTS The mean age of the patients was 54.9±45.7 months old. The PDAs were of type C (n=5), type D (n=12), and type E (n=3). The mean pulmonary end diameter of the PDA was 1.7±0.6 mm, and the aortic end diameter was 3.6±1.4 mm. The mean length was 7.3±1.8 mm. We used 3 types of AVP devices: AVP I (n=5), AVP II (n=7), and AVP IV (n=8). The ratio of AVP size to the pulmonary end diameter was 3.37±1.64, and AVP size/aortic end ratio was 1.72±0.97. The aortic end diameter was significantly larger in those cases repaired with AVP II than in the others (P=0.002). The AVP size did not significantly correlate with the PDA size, but did correlate with smaller ratio of AVP size to aortic end diameter (1.10±0.31, P=0.032). CONCLUSION Transcatheter closure of small PDA with AVP devices yielded satisfactory outcome. AVP II was equally effective with smaller size of device, compared to others.
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Affiliation(s)
- Eun Hyun Cho
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Lee HY, Her SH, Park MW, Choi MS, Cho JS, Kim CJ, Kang HS, Choi YA, Ju IN, Kim SA, Lee JH, Kwon JB, Park K. A case of patent ductus arteriosus with congestive heart failure in a 80-year-old man. Korean Circ J 2013; 42:849-52. [PMID: 23323124 PMCID: PMC3539052 DOI: 10.4070/kcj.2012.42.12.849] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2012] [Revised: 05/15/2012] [Accepted: 05/29/2012] [Indexed: 11/26/2022] Open
Abstract
Patent ductus arteriosus (PDA) is a rare clinical finding in adult patients. Considering the increase in cases of PDA discovered incidentally on echocardiograms at young ages, and the life-shortening effect of PDA, it is rare to diagnose PDA in old patients. We report a case of an 80-year-old patient who experienced symptoms of congestive heart failure showed findings suggestive of PDA in echocardiogram and confirmed the diagnosis through a cardiac catheterization and a coronary angiography. After percutaneous occlusion of PDA with an Amplatzer duct occlusion device, symptoms related to congestive heart failure improved.
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Affiliation(s)
- Hye Yeon Lee
- Division of Cardiology, Daejeon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
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Affiliation(s)
- Yukiharu Sugimura
- Department of Cardiovascular Surgery, Fuji Heavy Industries Health Insurance Society Ota Memorial Hospital, Japan
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Htwe TH, Khardori NM. Cardiac emergencies: infective endocarditis, pericarditis, and myocarditis. Med Clin North Am 2012; 96:1149-69. [PMID: 23102482 DOI: 10.1016/j.mcna.2012.09.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Cardiac infections presenting as emergencies include complications of infective endocarditis, including congestive heart failure, chordae tendinae rupture, cardiac arrhythmias, and embolic phenomenon; acute pericarditis, including cardiac tamponade; and acute myocarditis presenting with malignant cardiac arrhythmias or congestive heart failure. Most of these emergent infectious disease manifestations of the cardiovascular system have a good prognosis if diagnosed early and managed appropriately. Newer diagnostic modalities and combined treatment guidelines are available from the European Society of Cardiology and the American Heart Association.
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Affiliation(s)
- Tin Han Htwe
- Division of Infectious Diseases, Sentara Medical Group, Norfolk, VA 23502-3979, USA
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Rafał Poliwczak A, Koziróg M, Zabielska J, Bała A, Lipiec P, Broncel M. Persistent ductus arteriosus in a 72-year-old woman with paroxysmal atrial fibrillation and depression syndrome: a therapeutic and diagnostic problem. Arch Med Sci 2011; 7:914-7. [PMID: 22291842 PMCID: PMC3258805 DOI: 10.5114/aoms.2011.25572] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2010] [Revised: 10/01/2010] [Accepted: 10/03/2010] [Indexed: 11/17/2022] Open
Abstract
Treating the elderly is often problematic, especially when congenital heart disease is diagnosed. The aim of this study is to present the case of a 72-year old woman with depression syndrome, paroxysmal atrial fibrillation and past cerebral stroke, in whom persistent ductus arteriosus Botalli was diagnosed. Due to exacerbation of the depressive syndrome, she did not give her consent to further diagnostics, possible interventional procedures and treatment with oral anticoagulants. After intermission of the therapy she was treated with dabigatran. The patient is still undergoing outpatient treatment and so far, no cerebrovascular episodes have been recorded.
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Affiliation(s)
- Adam Rafał Poliwczak
- Department of Internal Diseases and Clinical Pharmacology, Medical University of Lodz, Poland
| | - Marzena Koziróg
- Department of Internal Diseases and Clinical Pharmacology, Medical University of Lodz, Poland
| | - Justyna Zabielska
- Department of Internal Diseases and Clinical Pharmacology, Medical University of Lodz, Poland
| | - Agnieszka Bała
- Department of Internal Diseases and Clinical Pharmacology, Medical University of Lodz, Poland
| | - Piotr Lipiec
- Department of Cardiology, Medical University of Lodz, Poland
| | - Marlena Broncel
- Department of Internal Diseases and Clinical Pharmacology, Medical University of Lodz, Poland
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Fortescue EB, Lock JE, Galvin T, McElhinney DB. To close or not to close: the very small patent ductus arteriosus. CONGENIT HEART DIS 2010; 5:354-65. [PMID: 20653702 DOI: 10.1111/j.1747-0803.2010.00435.x] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Patent ductus arteriosus (PDA) accounts for approximately 10% of all congenital heart diseases, with an incidence of at least 2-4 per 1000 term births. Closure of the large, hemodynamically significant PDA is established as the standard of care, and can be performed safely and effectively using either surgical or transcatheter methods. The appropriate management of the very small, hemodynamically insignificant PDA is less clear. Routine closure of such defects has been advocated to eliminate or reduce the risk of infective endocarditis (IE). However, the risk of IE in patients with a small PDA appears to be extremely low, and IE is treatable. Although closure of the small PDA is generally safe and technically successful, it is unknown whether this treatment truly improves the risk:benefit balance compared with observation. In this article, we review the published literature on the natural history and treatment outcomes in individuals with a PDA, the epidemiology and outcomes of IE, particularly in association with PDA, and the rationale and evidence for closure of the very small PDA.
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Affiliation(s)
- Elizabeth B Fortescue
- Harvard Medical School and Department of Cardiology, Children's Hospital Boston, Boston, MA, USA
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Ampanozi G, Ruder TD, Hatch GM, Bolliger S, Thali MJ. Incidental findings in post-mortem CT: Calcified ligamentum arteriosum. Leg Med (Tokyo) 2010; 12:313-5. [DOI: 10.1016/j.legalmed.2010.07.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2010] [Revised: 07/28/2010] [Accepted: 07/29/2010] [Indexed: 10/19/2022]
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Aoyagi S, Chihara S, Fukunaga S, Mori R, Suda K. Transcatheter coil embolization for patent ductus arteriosus in the elderly: report of a case and review of the published work. Geriatr Gerontol Int 2009; 9:329-32. [PMID: 19702946 DOI: 10.1111/j.1447-0594.2009.00541.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
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.
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Affiliation(s)
- Shigeaki Aoyagi
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan.
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Kim SY, Lee SH, Kim NK, Choi JY, Sul JH. A new strategy for transcatheter closure of patent ductus arteriosus with recent-generation devices. KOREAN JOURNAL OF PEDIATRICS 2009. [DOI: 10.3345/kjp.2009.52.4.488] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Sang Yee Kim
- Division of Pediatric Cardiology, Department of Pediatrics, Severance Cardiovascular Center Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Soo Hyun Lee
- Division of Pediatric Cardiology, Department of Pediatrics, Severance Cardiovascular Center Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Nam Kyun Kim
- Division of Pediatric Cardiology, Department of Pediatrics, Severance Cardiovascular Center Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Jae Young Choi
- Division of Pediatric Cardiology, Department of Pediatrics, Severance Cardiovascular Center Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Jun Hee Sul
- Division of Pediatric Cardiology, Department of Pediatrics, Severance Cardiovascular Center Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea
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