Pulmonary artery rupture in pregnancy complicating patent ductus arteriosus

Fatal haemopericardium in a 27 year old pregnant woman was caused by rupture of a dissecting aneurysm of the pulmonary artery. She had an uncorrected patent ductus arteriosus and severe pulmonary hypertension. The wall of the pulmonary artery showed atherosclerosis and cystic medionecrosis.     

Pulmonary artery rupture in pregnancy complicating patent ductus arteriosus

Fatal haemopericardium in a 27 year old pregnant woman was caused by rupture of a dissecting aneurysm of the pulmonary artery. She had an uncorrected patent ductus arteriosus and severe pulmonary hypertension. The wall of the pulmonary artery showed atherosclerosis and cystic medionecrosis.     

Pulmonary artery aneurysms in patent ductus arteriosus

Two cases of pulmonary artery aneurysm are reported in patients with persistent ductus arteriosus (PDA). The first was a mycotic aneurysm complicating staphylococcal pneumonia; the other was a calcific aneurysm of the right pulmonary artery. The mycotic origin was confirmed in the first case. The aetiological roles of pulmonary hypertension and previous endocarditis are discussed in the second case. Based on these two observations, the authors analyse the aetiology and evolution of mycotic aneurysms and review the therapeutic problems posed by their association with PDA.     

Hemolysis complicating coil occlusion of patent ductus arteriosus

We report on 5 patients who developed hemolysis (the Hemolysis group) following coil occlusion for PDA, and compare their data to 66 cases which were not complicated by hemolysis despite residual leak (the No Hemolysis group). A significant leak with a heart murmur was more frequent in the Hemolysis group than in the No Hemolysis group. The ratio of the sum of the loop diameter of coils to the minimal diameter of the ductus (C/D) in those who developed persistent hemolysis that needed a second intervention (2.2 ± 0.4) was significantly smaller than in the No Hemolysis group (3.1 ± 1.1). Persistent hemolysis can occur if a significant residual shunt remains after implantation of coils with small C/D. As this complication may be avoided by complete closure or, if not complete, a minimal leak, we should be careful to make residual leaks as small as possible by the use of multiple coils. Cathet. Cardiovasc. Diagn. 43:50–53, 1998. © 1998 Wiley-Liss, Inc.     

Pulmonary artery velocity patterns in ductus arteriosus.

Cross sectional and M mode echocardiography detected a large right atrial mass in a 70 year old man five days after admission. Three weeks later he developed acute respiratory failure due to a pulmonary embolism. Necropsy showed that the atrial mass was a thrombus. Thus echocardiography should be performed in patients with pulmonary emboli to examine the right cardiac cavities. The need for emergency surgery could then be assessed.     

Pulmonary arteriography through patent ductus arteriosus with preformed catheters

Selective pulmonary arteriography was performed successfully with new preformed catheters in eight consecutive patients with pulmonary atresia or severe stenosis and patent ductus arteriosus. The catheters were inserted percutaneously into the femoral artery and passed into the patent ductus arteriosus very easily within a few minutes. Pulmonary arteriography was performed with biplane cineangiography. All eight patients showed either stenosis or secondary atresia in the central pulmonary artery. The obstructive lesions occurred at the junction of either a patent ductus arteriosus or a surgically anastomosed subclavian artery.     

False aneurysm complicating ligation of patent ductus arteriosus operated on successfully

Postoperative aneurysm of ductus arteriosus is a rare complication but may be lethal without treatment. It is less frequent than spontaneous aneurysm of ductus arteriosus. We report the case of 5 years-old girl who underwent a ligation of patent ductus arteriosus complicated, 6 months later, with a false aneurysm of ductus arteriosus and endocarditis of the ductus and the aortic valve. The diagnosis of the aneurysm was suspected on the anteroposterior chest X-ray which showed a left superior mediastinal opacity and confirmed by echocardiography. Through bilateral thoracotomy, an anevrismorraphy and aortic repair was carried out without problem. The postoperative course was unremarkable.     

Coil occlusion of patent ductus arteriosus.

BACKGROUND: Coils are the only devices available for transcatheter occlusion of patent ductus arteriosus (PDA) in Japan. Since April 1999, we have introduced a 0.052-inch Gianturco coil (0.052-inch coil) to close PDA >or=2.5 mm. METHODS AND RESULTS: A retrospective survey of the outcome of coil occlusions for PDA >or=2.5 mm before and after the 0.052-inch coil became available found that (1) the frequency of PDA >or=2.5 mm among all candidates for coil occlusion significantly increased after the availability of a 0.052-inch coil (p<0.01); (2) deployment complicated by migration (p<0.01), and prolonged procedure time (p<0.05) were significantly decreased after the introduction of the 0.052-inch coil. In a multivariate logistic regression model for uneventful deployment adjusted for age, pulmonary to systemic flow ratio, and use of a 0.052-inch coil, use of the 0.052-inch coil significantly decreased eventful deployment (p<0.05); and (3) successful deployment of a coil for PDA >or=4 mm significantly increased with the 0.052-inch coil (p<0.01). Complete occlusion was achieved once deployment was successful. CONCLUSION: Introduction of the 0.052-inch coil decreased complicated coil occlusion deployment for PDA >or=2.5 mm, and contributed to a better likelihood of coil occlusion for PDA >or=4 mm.