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- Title
Pseudoaneurysm of Patent Ductus Arteriosus Following Previous PDA Closure: Case Report and Literature Review.
- Authors
Mikael, Amarseen; Andacheh, Iden; Yufa, Ann; Nurick, Harvey
- Abstract
Background: Pseudoaneurysm developing after repair of a patent ductus arteriosus (PDA) is uncommon, with only a handful of cases reported in the literature. While older literature cites infection, recent series suggest that formation of pseudoaneurysm off of a ligated PDA attributed to breakdown in the suture line. Thoracic endovascular aortic repair (TEVAR) for this rare pathology has been demonstrated in selected case reports. Methods/Results: A 61-year-old woman presented with enlarging left chest mass and shortness of breath. The patient reported a history of a PDA with 2 attempts at closure. At age 6, she had undergone an attempt at endovascular closure of the PDA; this subsequently resulted in right lower extremity limb ischemia with resultant below-knee amputation. At age 12, she underwent open thoracotomy with ligation of the PDA; at this procedure, she had injury to her recurrent laryngeal nerve, resulting in permanent hoarseness of voice. A computed tomography angiogram of the chest was obtained, which demonstrated a saccular 4.5 × 3.8 cm pseudoaneurysm in the region of the PDA with calcific wall changes. Recommendation was made to proceed with operative repair and she agreed. A TEVAR was performed using a commercially available stent graft. During the procedure, intravascular ultrasound was performed; however, the connection between the PDA pseudoaneurysm and the aorta was not visualized. She had an uncomplicated operative and postoperative course. Follow-up imaging showed complete thrombosis of the pseudoaneurysm. Conclusions: Pseudoaneurysm from previous PDA repair is a rare pathology. We present a unique case in which the patient had undergone attempts at both endovascular and open surgical repair. Open repair for PDA is still advocated; however, TEVAR appears to be a safe treatment in adults with this pathology following failed open closure.
- Subjects
BLOOD vessels; ENDOVASCULAR surgery; COMPUTED tomography; DYSPNEA; PATENT ductus arteriosus; THERAPEUTIC complications; TREATMENT effectiveness; FALSE aneurysms; THORACIC aneurysms
- Publication
Vascular & Endovascular Surgery, 2020, Vol 54, Issue 2, p165
- ISSN
1538-5744
- Publication type
Article
- DOI
10.1177/1538574419886191