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CASE REPORT
Year : 2017  |  Volume : 5  |  Issue : 1  |  Page : 17-20

Role of multimodality imaging in postsurgical calcified aneurysm of patent ductus arteriosus


1 Rajaie Cardiovascular Medical and Research Center, Echocardiography Research Center, Iran University of Medical Sciences, Tehran, Iran
2 Rajaie Cardiovascular Medical and Research Center, Radiology Research Center, Iran University of Medical Sciences, Tehran, Iran
3 Rajaie Cardiovascular Medical and Research Center, Interventional Research Center, Iran University of Medical Sciences, Tehran, Iran
4 Rajaie Cardiovascular Medical and Research Center, Cardiac Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran

Correspondence Address:
Dr. Anita Sadeghpour
Rajaie Cardiovascular Medical and Research Center, Echocardiography Research Center, Iran University of Medical Sciences, Tehran
Iran
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ACVI.ACVI_2_18

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A patent ductus arteriosus (PDA) is a common congenital malformation in pediatric patients and accounts for 7%–10% of congenital heart diseases. The PDA is a posttricuspid shunt resulting from an arterial communication between the upper descending aorta and the distal pulmonary artery, is an important part of a normal fetal cardiac anatomy and usually closes spontaneously within 1 week after birth. Closure is indicated in patients with significant related symptoms, history of endarteritis, or dilation of the left atrium and/or the left ventricle (LV). Before the development of percutaneous PDA closure, surgical closure was recommended as the main routine treatment. An occasional occurrence is the recanalization of a surgically ligated ductus arteriosus, which may be associated with the serious complication of aneurysm formation. Herein, we report a rare case of a longstanding neglected PDA aneurysm as a complication of postsurgical PDA closure and discuss the weaknesses and strengths of cardiac imaging in this regard. A 31-year-old man with a history of surgical ligation of the PDA 20 years ago was referred to us for preoperative evaluation before elective noncardiac surgery. Electrocardiography revealed a normal sinus rhythm and an LV volume-overload pattern. Severe LV enlargement and moderate systolic dysfunction associated with a large residual PDA were found on transthoracic echocardiography. Cardiac catheterization and cardiac computed tomography angiography confirmed the presence of a calcified aneurysm of PDA, which was not suitable for percutaneous PDA closure. The patient underwent successful surgical closure without any residue or complications.


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