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[Endoluminal occlusion, using a catheter, of patent ductus arteriosus in an adult]
1Service de chirurgie cardiaque, hôpital Marie-Lannelongue, universitéParis-Sud, Le Plessis-Robinson.
Insights
Surgical closure of patent ductus arteriosus in adults carries higher risks. Venous catheterization with a Rashkind umbrella offers a less invasive alternative, reducing complications and hospital stay.
Area of Science:
- Cardiology
- Interventional Cardiology
- Adult Congenital Heart Disease
Background:
- Surgical closure of patent ductus arteriosus (PDA) in adults presents significant risks compared to pediatric patients.
- Advancements in interventional cardiology now allow for less invasive PDA occlusion via venous catheterization.
Observation:
- A 63-year-old woman with a confirmed PDA underwent diagnostic catheterization and aortography to define lesion anatomy.
- Pulmonary hypertension reversibility was assessed using balloon catheter occlusion of the PDA prior to device deployment.
Findings:
- A 17 mm Rashkind umbrella was successfully deployed to completely occlude the patent ductus arteriosus.
- This percutaneous transcatheter technique avoided the morbidity associated with thoracotomy, general anesthesia, and blood transfusion.
Implications:
- Transcatheter closure of PDA using a Rashkind umbrella offers a safer and more efficient alternative to surgery in adults.
- Reduced hospital stay (3 days) and absence of surgical complications significantly improve patient outcomes and recovery.
Abstract:
The risk of surgical closure of the ductus arteriosus in the adult is greater than in children. The ductus arteriosus can now be occluded by venous catheterisation using a Rashkind umbrella. This procedure vas performed in a 63 year old woman. The diagnosis was confirmed and the anatomy of the lesion defined by catheterisation with aortography. The patent ductus was then occluded with a balloon catheter to assess the reversibility of the pulmonary hypertension. A 17 mm Rashkind umbrella was then used to completely occlude the ductus. The advantages of the method over surgical closure are: absence of morbidity related to thoracotomy, to general anaesthesia, to blood transfusion and the reduction of hospital stay to 3 days.