Back to Annual Meeting ePosters

OBJECTIVE: Open surgery carries a high risk because of calcified fragile aortic tissue around adult patent ductus arteriosus (PDA). Recently, thoracic endovascular aortic repair (TEVAR) has emerged as an alternative treatment of adult PDA. We report here our two experiences in treating with adult PDA with TEVAR.
METHODS: Case 1: A 58-year-old female was diagnosed with PDA and paroxysmal atrial fibrillation. Transthoracic echocardiography (TTE) showed large PDA with a left-to-right shunt. The pulmonary/systemic flow ratio (Qp/Qs) was 2.1 in her angiography. Case 2: A 59-year-old male was diagnosed with PDA and severe aortic regurgitation (AR) with low LV function. TTE showed LV end-diastolic and systolic diameter (Dd/Ds) and ejection fraction were 74/68 and 17%, with large PDA. The Qp/Qs was 2.2 in his angiography. Two-staged operation was planned as TEVAR for PDA at first, and aortic valve replacement (AVR) for AR next.
RESULTS: TEVAR were successfully performed in both cases using home-made stent graft and Gore-TAG. Postoperative TTE and CT showed disappearance of PDA flow. LVDd/Ds decreased from 60/37 to 53/42 mm in case 1, and from 74/68 to 73/60 in case 2, postoperatively. Systolic pulmonary arterial pressure decreased from 38 to 28 mmHg in case 1, and from 40 to 36 in case 2. Although his cardiac function showed no significant improvement after TEVAR in case 2, AVR was performed successfully 4 months after the PDA closure. There was no complication either after the operation or during follow-up in both cases.
CONCLUSIONS: Our results of TEVAR of PDA are encouraging. TEVAR might be a therapeutic alternative for patent PDA in elderly patients.