Related Experiment Video
Updated: Mar 27, 2026
Closure of a Patent Foramen Ovale PFO: An Intervention Sequence
Published on: December 23, 2022
Percutaneous vascular plug closure of persistent ductus venosus presenting with elevated liver enzyme in a 6-year-old
Özlem Bayram1, Mehmet Gökhan Ramoğlu1, Emre Can Çelebioğlu2
1Department of Pediatric Cardiology, Ankara University School of Medicinehttps://ror.org/01wntqw50, Türkiye.
Insights
Postnatal persistence of the ductus venosus (PDV) is a rare condition causing porto-systemic shunts. Endovascular closure successfully treated PDV in a pediatric patient, normalizing liver function.
Area of Science:
- Vascular Surgery
- Pediatric Cardiology
- Hepatology
Background:
- Postnatal persistence of the ductus venosus (PDV) is a rare congenital vascular anomaly.
- PDV can lead to secondary portal vein hypoplasia and porto-systemic shunting.
- Clinical presentation varies, from infantile cholestasis to asymptomatic cases discovered later in life.
Purpose of the Study:
- To report a case of PDV in a 6-year-old male with a history of hepatic dysfunction.
- To describe the successful endovascular closure of PDV.
- To highlight the importance of portal venous pressure monitoring during the procedure.
Main Methods:
- Diagnosis of PDV in a 6-year-old male with elevated liver enzymes.
- Planning and execution of endovascular closure using a vascular plug.
- Pre- and post-procedure portal venous pressure measurement via balloon occlusion test.
Main Results:
- Successful percutaneous occlusion of the ductus venosus.
- Post-intervention ultrasonography confirmed complete closure and increased portal vein flow.
- Normalization of liver function tests during follow-up, with persistent mild transaminase elevation.
Conclusions:
- Endovascular closure is a viable, minimally invasive treatment for PDV.
- The balloon occlusion test is crucial for assessing the safety of shunt closure by measuring portal venous pressure.
- PDV management requires careful consideration of the wide spectrum of clinical presentations.
Abstract:
The ductus venosus plays a critical role in fetal circulation. Postnatal persistence of the ductus venosus (PDV) is associated with secondary portal vein hypoplasia and results in a porto-systemic shunt. In this extremely rare case, we present a 6-year-old male diagnosed with PDV, who had a history of elevated liver enzymes and mild hepatic dysfunction first detected at 11 months of age. Due to the presence of PDV, endovascular closure was planned. Portal venous pressure was measured as 10 mmHg both before and after balloon occlusion. Percutaneous occlusion was successfully performed using a vascular plug. Post-intervention ultrasonography confirmed complete occlusion of the ductus venosus and increased portal vein flow. During follow-up, liver function tests returned to normal; a slight elevation in transaminases persists. PDV is a rare congenital vascular anomaly that may present with a wide spectrum of clinical symptoms. While some patients may be diagnosed during early infancy due to cholestatic jaundice, hepatic dysfunction, or hyperammonaemia, others may remain asymptomatic and undiagnosed for years. Endovascular closure represents a minimally invasive treatment option. A balloon occlusion test to measure portal venous pressure is recommended before and after the procedure to evaluate the safety of shunt closure.
Related Concept Videos
01:29Venous Thrombosis III: Interprofessional Care
01:22Formation of the Platelet Plug
As the injured blood vessel contracts, endothelial cells undergo contraction, revealing collagen fibers in the basement membrane and underlying connective tissue. Furthermore, the plasma membrane of endothelial cells becomes adhesive, preparing the site for platelet adhesion. Platelets...