Successful Closure of a Patent Ductus Arteriosus Using an Aortic Stent Graft (original) (raw)
Surgical treatment for patent ductus arteriosus in adult patients: a single center experience
Romanian Journal of Morphology and Embryology
In contemporary practice, percutaneous closure of the patent ductus arteriosus (PDA) has become the procedure of choice. While the surgical ligation of ductus arteriosus ensures an immediate and definitive obliteration of the ductus, this therapeutic option is rarely used and reserved for situations when percutaneous solution is unsuitable. In this manuscript, we summarize the clinical and intraoperative findings of consecutive adult patients referred to our Institution in an interval of 10 years for surgical treatment of PDA. A total of five cases of surgical closure for PDA were performed in our Center. Four subjects were not suitable for percutaneous closure, and one was discovered intraoperatively, during surgery for another cardiac condition. In all patients, the closure of the PDA was carried out by means of a suture with reinforced patch threads, in a double layer. The intervention was performed in total cardiopulmonary bypass and mild or moderate hypothermia, through a transpulmonary approach. Total circulatory arrest was not required, in any of the cases. The occlusive balloon technique was applied to all patients. All patients survived the intervention and did not suffer perioperative complications. Postoperative follow-up at 36 months did not show repermeabilization of the arterial duct or aneurysmal dilation of the adjacent aorta. Moreover, all patients showed postoperative improvement in the performance of the left ventricle. In adult patients with PDA and contraindication to percutaneous closure or in those who require surgical sanction for other cardiac diseases, surgical closure of the duct is safe and associated with favorable clinical evolution.
Catheterization and Cardiovascular Interventions, 2003
A 19-year-old girl with coarctation of the aorta and patent ductus arteriosus underwent simultaneous treatment of native coarctation and closure of ductus arteriosus using a covered Cheatham-Platinum stent. This technique may be used as an alternative to other forms of interventional therapy or surgery for this combination of lesions in adolescents and adults. Cathet Cardiovasc Intervent 2003;59:387–390. © 2003 Wiley-Liss, Inc.
Results of Closure of Patent Ductus Arteriosus in Adult Population Using Cardiopulmonary Bypass
The Egyptian Journal of Hospital Medicine
Background: Surgical repair of patent ductus arteriosus (PDA) in adults is more challenging compared to children. This study was conducted to report our experience using cardiopulmonary bypass (CPB) in adult cases with PDA. Aim of the work: The objective of this study is to evaluate the safety and efficacy of the usage of the cardiopulmonary bypass in management of PDA in the adult population, not suitable for trans-catheter closure. Patients and methods: This is a retrospective study that included all adult cases with PDA who had surgical closure for 5 years (July 2014 to July 2019
Anatolian journal of cardiology, 2018
To report clinical and procedural characteristics of twelve patients who received a covered stent for the treatment of aortic coarctation and concurrent patent ductus arteriosus (PDA). A single center database was retrospectively evaluated to obtain data of patients with combined aortic coarctation and PDA. We selected patients in whom a covered stent was used for the treatment of both pathologies. The stent length was chosen so as to cover the entire length of the lesion from healthy to healthy tissue and also cover the ampulla of PDA. The median age of the patients was 15 (range, 6.5-35) years. The diameter of the coarctated segment increased from a median of 8.4 (range, 2.6-10.8) mm to 16 (range, 9-24) mm (p<0.005), whereas the pressure gradient decreased from a median of 43 (range, 10-71) mm Hg to 0 (range, 0-8) mm Hg (p<0.005). Fourteen covered stents were used for 12 patients. Following deployment, seven stents were flared with larger and low-pressure balloons because of...
Transfemoral closure of patent ductus arteriosus in adult patients
International Journal of Cardiology, 1993
Patent ductus arteriosus is an uncommon anomaly in adult patients. Surgical closure of patent ductus arteriosus in this age group presents difficult problems to.the surgeon. We report our experience of 21 adult patients (19-62 years of age, mean 40 years) who underwent closure of the ductus by transfemoral implantation of a Rashkind double umbrella device. The patients came to light because of atria1 fibrillation, congestive heart failure, residual flow after surgical ligation of the duct or because of incidental diagnosis made during physical examination or chest X-ray. In ten patients the pulmonary arterial pressure was normal (systolic pressure < 30 mmHg), in eleven it was elevated (systolic pressure from 30 to 100 mmHg, mean 50 mmHg). In seven patients the duct was clearly calcified and the size of the duct varied from 3 to 9 mm (mean 4.3 mm). In 16 patients the ductus resulted perfectly closed after implantation of the first double umbrella device, two patients had minimal residual aortopulmonary flow, whereas in three patients the residual shunt was significant; two of these also developed haemolysis and went to surgery, in the latter the shunt was completely abolished after implantation of a second 17-mm device 16 months later. In conclusion transcatheter closure of patent ductus arteriosus in adults is feasible, even in the presence of calcifications and/or pulmonary hypertension; taking into account the significant surgical risk, PDA umbrella closure should be considered the first choice procedure in this group of patients.
Treatment paradigms for ductus arteriosus aneurysms in adults
Vascular, 2014
We report two symptomatic cases of ductus arteriosus aneurysm (DDA) in adults treated in our department over a 5-years period. One patient underwent an open off-pump surgical procedure, while the second one was treated with partial aortic arch debranching and endovascular stent-grafting. DDA in adults is an uncommon condition and can present with rupture, hoarseness or symptoms of airway obstruction. Although indications for intervention are not clearly established, most authors advocate that DDAs should be treated regardless of their size, to avoid the risk of rupture, while others reserve intervention for symptomatic patients. We report on the management of these patients and provide an updated review of the current literature.
Specific Aspects of Percutaneous Closure of Patent Ductus Arteriosus in Adult Patients
Revista Brasileira de Cardiologia Invasiva English Version, 2013
background: Percutaneous closure of patent ductus arteriosus is a safe, effective and easily reproducible method. Adult patent ductus arteriosus may present degenerative changes that increase surgical risk and favor percutaneous closure. We report a single center experience with percutaneous closure of patent ductus arteriosus in adults and highlight specific technical aspects of this procedure. Methods: The records of patients ≥ 20 years of age submitted to patent ductus arteriosus closure between March 2001 and December 2012 were evaluated. Cases were selected by transthoracic echocardiography. results: We analyzed 33 patients, most of them females (72.7%), with mean age of 30.9 ± 12.8 years and weight of 63.9 ± 12.4 kg. Only 3 patients had symptoms and 2 had associated congenital defects, treated in the same procedure. Implants were possible in all cases. One Flipper Coil, 19 Amplatzer TM Duct Occluders type I, 3 Amplatzer TM Duct Occluders type II, 8 Cera TM PDA Occluders and 2 Muscular VSD devices were used. Sizing balloons were used in 5 cases. Mean follow-up was 46.1 ± 42.9 months and was obtained in 84.9% of patients. Two cases presented residual shunts immediately after the procedure. There were no major complications or deaths. Conclusions: Percutaneous closure of adult patent ductus arteriosus may be performed safely and effectively with the devices used in this study.
Interventional treatment of patent ductus arteriosus in 2004
Catheterization and Cardiovascular Interventions, 2005
In 2004, the interventional treatment of patent ductus arteriosus (PDA) is definitive and curative. In current practice, coils are used for smaller PDA, and devices are employed for larger PDA. Developing technologies offer small improvements in control and results, but do not appear to promise major changes in practice. This review summarizes the current and emerging interventional technologies directed at PDA closures. Catheter Cardiovasc Interv 2005;64:91-101. ' 2004 Wiley-Liss, Inc.