Analysis of infective endarteritis in patent ductus arteriosus (original) (raw)
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Echocardiographic findings in patent ductus arteriosus-associated infective endarteritis
The Anatolian Journal of Cardiology, 2021
Objective: Infectious endarteritis associated with patent ductus arteriosus (PDA-IE) is an uncommon complication in the era of antibiotics. However, it implies a clinical challenge in patients with a fever of undetermined origin. Two-dimensional transthoracic echocardiography (TTE) plays a fundamental role in diagnosis and follow-up. Methods: A retrospective analysis of the data of all patients admitted to our center with PDA-IE within 15 years was conducted, and a review of the literature regarding diagnosis, TTE findings, and treatment was performed. Results: A total of 17 patients were identified with a mean age of 17.8 years. TTE done in all patients confirmed the diagnosis of PDA and pulmonary artery vegetation. In five patients, one vegetation was present; in three patients, two vegetations were found; and in the nine remaining patients, three or more vegetations were observed. In two-thirds of the patients, the size of the vegetation was three to 28 mm, and the principal morphology was filiform. In all patients, at least one vegetation developed on the lateral wall of the ductus arteriosus. Pulmonary valve was affected in 41% of the patients and caused low to moderate valvular regurgitation. Pulmonary embolism was present in seven patients and pulmonary aneurysm in one patient. Conclusion: The incidence of PDA-IE has decreased in the recent years with early antibiotic therapy. However, today, this complication carries a significant risk of valve damage and other cardiac structures' involvement.
Archives of Cardiovascular Diseases, 2009
Background. -Despite the availability of effective devices, percutaneous closure of patent ductus arteriosus (PDA) can be challenging in some situations. Aim. -To describe our initial experience of percutaneous PDA closure. Methods. -Between 2001 and 2007, 73 consecutive patients aged 3 months to 70 years underwent transcatheter PDA closure. An Amplatzer duct occluder (ADO) was chosen for ducts greater than 2 mm (n = 50) and a Detachable coil (DC) for smaller ducts (n = 23). Results. -The diameter of the ducts ranged from 1 to 7.2 (mean 2.9 ± 1.3) mm. The prostheses were implanted successfully in all patients. The complete closure rate reached 98% in the ADO group and 100% in the DC group at 12 months. Four (5.4%) patients showed asymptomatic device protrusion: three patients (5, 6 and 10 kg) into the aortic isthmus and one patient (7 kg) into the pulmonary artery (PA). One patient (7 kg) experienced transient severe bradycardia due to pulmonary air embolism. Another patient (3.3 kg) had a permanent asymptomatic occlusion of the femoral artery. In a third patient (17 kg), the ADO migrated asymptomatically into the descending aorta and was discovered 12 months later.
Pulmonary and aortic endarteritis revealing a patent ductus arteriosus in an adult : a case report
2020
Background The ductus arteriosus, an essential fetal structure, normally closes spontaneously soon after birth. It’s persistence into late adulthood is considered rare; infective endarteritis complicating a patent ductus arteriosus (PDA) is an even rarer event. The clinical picture of an infected PDA could be subtle, and the diagnosis is frequently delayed. Case presentation We present the case of a young women who presented with prolonged fever, in whom we made the diagnosis of a patent ductus arteriosus complicated by infective endarteritis with vegetations in both pulmonary and aortic wall with mycotic aneurysms of the descending aorta. She underwent surgery and postoperative course was uneventful. Conclusion To our knowledge, this is the first reported case of a patent ductus arteriosus complicated with both pulmonary and aortic endarteritis.