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A case of adult patent ductus arteriosus-associated infective endarteritis who was successfully treated with only antibiotics.

ABSTRACT: Patent ductus arteriosus-associated infective endarteritis (PDA-IE) is an extremely rare complication of PDA in recent years. In this report, we describe a case of PDA-IE complicated by septic pulmonary embolism who was successfully treated with only antibiotics.

SUBMITTER: Kanai A

PROVIDER: S-EPMC10014522 | biostudies-literature | 2023 Mar

REPOSITORIES: biostudies-literature

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A case of adult patent ductus arteriosus-associated infective endarteritis who was successfully treated with only antibiotics.

Kanai Akira A Chikata Yuichi Y Iwata Hiroshi H Ajima Tomohi T Kaneko Tomohiro T Murata Azusa A Kagiyama Nobuyuki N Fukushima Yoshifumi Y Miyazaki Sakiko S Minamino Tohru T

Clinical case reports 20230314 3

Patent ductus arteriosus-associated infective endarteritis (PDA-IE) is an extremely rare complication of PDA in recent years. In this report, we describe a case of PDA-IE complicated by septic pulmonary embolism who was successfully treated with only antibiotics. ...[more]

PMID: 36937627

Similar Datasets

Echocardiographic findings in patent ductus arteriosus-associated infective endarteritis.

Project description:BackgroundInfectious endarteritis associated with patent ductus arteriosus (PDA-IE) is an uncommon complication in the era of antibiotics. However, it implies a clinical challenge in patients with a fever of undetermined origin; Two-dimensional transthoracic echocardiography (TTE) performs a fundamental role in diagnosis and follow-up.MethodsA retrospective analysis was then made of the data of all patients admitted at our center with PDA-IE within 15 years, and a review of the literature regarding diagnosis, TTE findings, and treatment was performed.ResultsA total of 17 patients were identified. The mean age was 17.8 years. The TTE done in all patients confirmed the PDA and PA vegetations diagnosis; in five cases, one vegetation was present; in three cases, two vegetations were found, and in the nine remaining cases, three or more vegetations were observed. In two-thirds of the cases, the vegetations' size was 3 to 28 mm, and the principal morphology was filiform. In all cases, at least one of the vegetations was developed in the DA's lateral wall. Pulmonary valve (PV) was affected in 41% of the patients and caused low to moderate valvular regurgitation. Pulmonary embolism was present in 7 cases and pulmonary aneurism in one case.ConclusionsDecreased incidence of PDA-IE has been currently achieved with early antibiotic therapy. However, today, this complication carries a significant risk of valve damage and other cardiac structures' involvement.

| S-EPMC8575391 | biostudies-literature

Utility of Computed Tomography in Diagnosis of a Patent Ductus Arteriosus in Pulmonary Artery Endarteritis.

Project description:A 15-year-old patient with infective endarteritis had a pulmonary artery vegetation but no ductus arteriosus on echocardiogram. Computed tomography scan revealed a closed ductus that became patent after antibiotics and anticoagulation. Infective endarteritis should be considered in patients with a pulmonary artery vegetation even if no ductus is seen on echocardiogram. (Level of Difficulty: Intermediate.).

| S-EPMC9830465 | biostudies-literature

Patent ductus arteriosus mimicking hypertrophic cardiomyopathy.

Project description: Not available

| S-EPMC8617388 | biostudies-literature

Patent ductus arteriosus endarteritis in a 40-year old woman, diagnosed with transesophageal echocardiography. A case report and a brief review of the literature.

Project description: Not available

| S-EPMC153664 | biostudies-literature

Neonatal Patent Ductus Arteriosus Ligation Operations Performed by Adult Cardiac Surgeons.

Project description:Patent ductus arteriosus (PDA) ligation is usually performed by congenital cardiac surgeons. However, due to the uneven distribution of congenital cardiac surgeons in South Korea, many institutions depend solely on adult cardiac surgeons for congenital cardiac diseases. We report the outcomes of PDA ligations performed by adult cardiac surgeons at our institution.The electronic medical records of 852 neonates at Chung-Ang University Hospital, Seoul, South Korea from November 2010 to May 2014 were reviewed to identify patients with PDA.Of the 111 neonates with a diagnosis of PDA, 26 (23%) underwent PDA ligation. PDAs were ligated within 28 days of birth (mean, 14.5±7.8 days), and the mean gestational age of these patients was 30.3±4.6 weeks (range, 26 to 40 weeks) with a mean birth weight of 1,292.5±703.5 g (range, 480 to 3,020 g). No residual shunts through the PDA were found on postoperative echocardiography. There was 1 case of 30-day mortality (3.8%) due to pneumonia, and 6 cases of in-hospital mortality (23.1%) after 30 days, which is comparable to results from other centers with congenital cardiac surgery programs.Although our outcomes may not be generalizable to all hospital settings without a congenital cardiac surgery program, in select centers, PDA ligations can be performed safely by adult cardiac surgeons if no congenital cardiac surgery program is available.

| S-EPMC5548199 | biostudies-other

Eisenmenger syndrome in an adult patient with a large patent ductus arteriosus.

Project description:This is the case of a young female who was seen at our adult congenital heart disease and pulmonary hypertension service (Royal Brompton Hospital, London, UK) at the age of 17 years. She initially presented at the age of 4 years with increasing shortness of breath. At that time, there was differential cyanosis with clubbing and lower oxygen saturations in the toes (82%) compared with her fingers (95%). On echocardiography there was evidence of severe pulmonary hypertension and a large patent ductus arteriosus (PDA) with low velocity bidirectional shunting. She underwent cardiac catheterisation at the time which showed a pulmonary arterial pressure equal to that of the aorta.

| S-EPMC9639180 | biostudies-literature

Quadricuspid aortic valve with patent ductus arteriosus.

Project description: Not available

| S-EPMC3014131 | biostudies-literature

Patent Ductus Arteriosus of the Preterm Infant.

Project description:Postnatal ductal closure is stimulated by rising oxygen tension and withdrawal of vasodilatory mediators (prostaglandins, nitric oxide, adenosine) and by vasoconstrictors (endothelin-1, catecholamines, contractile prostanoids), ion channels, calcium flux, platelets, morphologic maturity, and a favorable genetic predisposition. A persistently patent ductus arteriosus (PDA) in preterm infants can have clinical consequences. Decreasing pulmonary vascular resistance, especially in extremely low gestational age newborns, increases left-to-right shunting through the ductus and increases pulmonary blood flow further, leading to interstitial pulmonary edema and volume load to the left heart. Potential consequences of left-to-right shunting via a hemodynamically significant patent ductus arteriosus (hsPDA) include increased risk for prolonged ventilation, bronchopulmonary dysplasia, necrotizing enterocolitis or focal intestinal perforation, intraventricular hemorrhage, and death. In the last decade, there has been a trend toward less aggressive treatment of PDA in preterm infants. However, there is a subgroup of infants who will likely benefit from intervention, be it pharmacologic, interventional, or surgical: (1) prophylactic intravenous indomethacin in highly selected extremely low gestational age newborns with PDA (<26 + 0/7 weeks' gestation, <750 g birth weight), (2) early targeted therapy of PDA in selected preterm infants at particular high risk for PDA-associated complications, and (3) PDA ligation, catheter intervention, or oral paracetamol may be considered as rescue options for hsPDA closure. The impact of catheter-based closure of hsPDA on clinical outcomes should be determined in future prospective studies. Finally, we provide a novel treatment algorithm for PDA in preterm infants that integrates the several treatment modalities in a staged approach.

| S-EPMC7605084 | biostudies-literature

Takotsubo syndrome following patent ductus arteriosus device closure.

Project description: Not available

| S-EPMC9373964 | biostudies-literature

Retrieval of patent ductus arteriosus device embolization using hybrid approach: a case report.

Project description:BackgroundPatent ductus arteriosus (PDA) is a congenital heart defect that requires closure to prevent complications like heart failure and pulmonary hypertension. Catheter-based closure using devices such as the Amplatzer duct occluder is the preferred method due to its minimally invasive nature. However, device embolization is a rare but recognized complication, particularly in small children or high-flow PDAs.Case presentationWe report a rare and complex case of spontaneous embolization of a PDA closure device into the descending aorta in an 11-month-old female. The patient, with a history of recurrent lower respiratory tract infections and poor weight gain, underwent a PDA closure procedure after a thorough assessment. During the procedure, the Amplatzer Duct Occluder I device unexpectedly migrated into the descending aorta. Despite initial attempts at percutaneous retrieval using a goose neck snare, the device lodged in the left common iliac artery due to size discrepancy. Further snaring was abandoned to prevent the risk of artery dissection. The patient was then taken for emergency surgical exploration. The cardiovascular surgical team successfully retrieved the device through a left supra-inguinal incision, with no complications post-surgery. The patient showed improved limb perfusion and was discharged one week later.ConclusionsThis case underscores the importance of meticulous procedural planning, multidisciplinary collaboration, and adaptive decision-making in managing rare and challenging complications during PDA device closure. The successful outcome, despite the complex nature of the complication, highlights the effectiveness of combining percutaneous and surgical approaches in pediatric cardiology.

| S-EPMC11662123 | biostudies-literature

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