Korean Circ J.  2012 Dec;42(12):849-852. 10.4070/kcj.2012.42.12.849.

A Case of Patent Ductus Arteriosus with Congestive Heart Failure in a 80-Year-Old Man

• 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

• KMID: 1491102
• DOI: http://doi.org/10.4070/kcj.2012.42.12.849

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.

Keyword

Ductus arteriosus, patent; Heart failure; Aged

MeSH Terms

Adult
Aged
Cardiac Catheterization
Cardiac Catheters
Coronary Angiography
Ductus Arteriosus, Patent
Estrogens, Conjugated (USP)
Heart Failure
Humans
Estrogens, Conjugated (USP)

Figure

• 

  Fig. 1 Initial chest X-ray shows cardiomegaly. CT ratio was 0.59. Pulmonary edema in both lungs without pleural effusion can be seen (A). The patient's cardiomegaly and pulmonary edema shows improvement after transcatheter closures of patent ductus arteriosus. CT ratio has decreased to 0.47 and symptoms related to heart failure improved without medical treatment including diuretics (B).

• 

  Fig. 2 CT scan with aorta and aortic angiogram finding suggest patent ductus arteriosus. A: sagittal view of CT scan shows connection between left pulmonary artery and distal aortic arch (arrow). B: aortic angiogram proves the shunt flow (arrow).

• 

  Fig. 3 A: occlusion of patent ductus arteriosus with the Amplatzer duct occlusion device is done. B: no more shunt flow is seen in follow-up aortogram after procedure (arrow).

Reference

1. Akintunde AA, Opadijo OG. Case report of a 26 year old primigravida with patent ductus arteriosus (PDA) in heart failure. Afr Health Sci. 2011. 11:138–140.

2. Cassidy HD, Cassidy LA, Blackshear JL. Incidental discovery of a patent ductus arteriosus in adults. J Am Board Fam Med. 2009. 22:214–218.

3. Satoh T, Yanagitani Y, Okano Y. Patent ductus arteriosus with combined valvular disease at age 91. Intern Med. 1997. 36:340–344.

4. Satoh T, Nishida N. Patent ductus arteriosus with infective endocarditis at age 92. Intern Med. 2008. 47:263–268.

5. Zhu XY, Chen HY, Zhang DZ, et al. Effects of transcatheter closure of patent ductus arteriosus in 139 adult patients. Zhonghua Xin Xue Guan Bing Za Zhi. 2009. 37:998–1000.

6. Wang JK, Wu MH, Hwang JJ, Chiang FT, Lin MT, Lue HC. Transcatheter closure of moderate to large patent ductus arteriosus with the Amplatzer duct occluder. Catheter Cardiovasc Interv. 2007. 69:572–578.

7. Harrison DA, Benson LN, Lazzam C, Walters JE, Siu S, McLaughlin PR. Percutaneous catheter closure of the persistently patent ductus arteriosus in the adult. Am J Cardiol. 1996. 77:1094–1097.

8. Giliberti P, De Leonibus C, Giordano L, Giliberti P. The physiopathology of the patent ductus arteriosus. J Matern Fetal Neonatal Med. 2009. 22:Suppl 3. 6–9.