Open AccessThoracic endovascular repair technique for the treatment of patent ductus arteriosus in an elderly patient
Author(s) -
Jung Hee Kim,
Jong Hyun Baek
Publication year - 2018
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000013558
Subject(s) - medicine , ductus arteriosus , aortography , surgery , thoracic aorta , radiology , stent , aorta , aortic repair , cardiothoracic surgery , cardiac catheterization
Rationale: Patent ductus arteriosus (PDA) ligation by open surgery is more difficult and dangerous in elderly patients than in infants. Nowadays, simple and safe interventional catheterization technology is used for the closure of uncomplicated isolated PDAs. Therefore, an alternative less invasive therapeutic option must be developed to treat complicated PDA. Patient concerns: A 53-year-old woman presented with gradually exacerbated dyspnea on effort and continuous cardiac murmurs. Diagnosis: Transthoracic echocardiography (TTE) and contrast-enhanced 3D computed tomography (CT) were performed and revealed a conically shaped large PDA with calcification. Interventions: We used a nontouch exclusion technique with thoracic endovascular repair (TEVAR) for the treatment of this rare complicated PDA. The patient had an adequate proximal landing zone, and a tapered stent graft (S&G, Bio 34–30 mm × 110 mm, Korea) was used. Outcomes: Aortography after stent graft implantation revealed complete occlusion of PDA and no endoleaks. The procedure was successful, and the patient showed no vascular or other complications during follow-up. Lessons: TEVAR is a less invasive solution for pathologies of the thoracic aorta, such as aortic dissection or aneurysm. TEVAR is an established, simple, and safe method for repairing the thoracic aorta and can be a new alternative to other transcatheter techniques for complicated PDAs in elderly patients.