Percutaneous closure of a large persistent ductus arteriosus in a pediatric patient with inferior vena cava interruption: a case report
DOI:
https://doi.org/10.58597/rpe.v3i2.83Keywords:
Patent ductus arteriosus, Heart defects congenital, Cardiac catheterization, Child, Intracardiac shuntsAbstract
Persistent ductus arteriosus (PDA) accounts for approximately 10% of congenital heart diseases. In pediatric patients, percutaneous closure with a device is the treatment of choice. Early intervention prevents progression to heart failure, pulmonary hypertension, and the risk of bacterial endarteritis. We present the case of a 7-year-old boy with a large PDA and an inferior vena cava anomaly, which drained into the azygos vein (interruption of the inferior vena cava). Studies showed dilation of the left heart chambers and a type A PDA with significant shunt. This condition complicated the percutaneous closure and posed a technical challenge. A therapeutic cardiac catheterization was performed, accessing through the femoral vein and using the azygos vein as a route. A MemoPart PDA Occluder device was successfully implanted, resulting in no complications and favorable postoperative follow-up. This is the first nationally reported case of successful PDA closure via cardiac intervention.
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References
Butera G, Chessa M, Eicken A, Thomson J, editors. Cardiac catheterization for congenital heart disease:from fetal life to adulthood. Milano: Springer; 2015 p 465-466.
Feltes TF, Bacha E, Beekman RR. Indications for cardiac catheterization and intervention in pediatric cardiac disease: a scientific statement from the American Heart Association. Circulation. 2011; 123(22):2607–2652. doi: 10.1161/CIR.0b013e31821b1f10.
Shah JH, bhalodiya DK, Rawal AP, Saraiya, SP. Safety and efficacy of transcatheter device closure of patent ductus arteriosus in pediatric patients: Long-term outcomes. Heart India 8(2):p 80-84, May–Aug 2020. DOI: 10.4103/heartindia.heartindia_6_20
Rajan P, Barwad P, Aggarwal P, Rohit MK. Patent Ductus Arteriosus Device Closure in Interrupted Inferior Vena Cava: Challenges Overcome and Lessons Learnt: A Case Series. Heart Views. 2021 Jan-Mar;22(1):71-75. doi: 10.4103/HEARTVIEWS.HEARTVIEWS_180_20.
Tefera E, Bermudez-Cañete R. Percutaneous closure of patent ductus arteriosus in interrupted inferior caval vein through femoral vein approach. Ann Pediatr Cardiol. 2014 Jan;7(1):55-7. doi: 10.4103/0974-2069.126560.
Akhtar S, Samad SM, Atiq M. Transcatheter closure of a patent ductus arteriosus in a patient with an anomalous inferior vena cava. Pediatr Cardiol. 2010 Oct;31(7):1093-5. doi: 10.1007/s00246-010-9745-2. Epub 2010 Jul 6. Erratum in: Pediatr Cardiol. 2010 Nov;31(8):1258. Akhtar, A [corrected to Akhtar, S].
Kern MJ. Cardiac catheterization techniques: normal hemodynamics. In uptodate: Cutlip D, Saperia GM (Ed). UpToDate Online. 2017, 3.8: 4.
Nishimura RA, Carabello BA. Hemodynamics in the Cardiac Catheterization Laboratory of the 21st Century. Circulation. 2012;125(17):2138-50. doi: 10.1161/CIRCULATIONAHA.111.060319.
Belloni F. Teaching the principles of hemodynamics. Am. J. Physiol. 1999; 277(22):187–202.
Malaki M, Willis AP, Jones RG. Congenital anomalies of the inferior vena cava. Clin Radiol. 2012; 67(2):165-71. doi: 10.1016/j.crad.2011.08.006.
Savirón Cornudella R, Pérez Pérez P, Allué Elena De D, Cisneros Gimeno A, Corona Bellostas C, Castán Mateo S. Interrupcion de vena cava inferior. Diagnóstico prenatal de sus variantes. Rev chil obstet ginecol. 2017; 82(6): 626-632. doi:10.4067/S0717-75262017000600626.
Al-Hamash S. Transcatheter closure of patent ductus arteriosus and interruption of inferior vena cava with azygous continuation using an Amplatzer duct occluder. Pediatr Cardiol. 2006 Sep-Oct;27(5):618-20. doi: 10.1007/s00246-006-1213-7.
Patel NH, Madan TH, Panchal AM, Thakkar BM. Percutaneous closure of patent ductus arteriosus via internal jugular vein in patient with interrupted inferior vena cava. Ann Pediatr Cardiol. 2009 Jul;2(2):162-4. doi: 10.4103/0974-2069.58321.
Viñals L. Fernando, Muñoz F. Marcela, Giuliano B. Arrigo. Marcadores sonograficos de cardiopatias congenitas. Interrupcion de la vena cava inferior: a proposito de nuestra experiencia y resultados. Rev Chil Obstet Ginecol. 2002; 67(4): 280-287. doi:10.4067/S0717-75262002000400003.
Koh GT, Ai Mokthar S, Hamzah A, Kaur J. Transcatheter closure of patent ductus arteriosus and interruption of inferior vena cava with azygous continuation using an Amplatzer duct occluder II. Ann Pediatr Cardiol. 2009 Jul;2(2):159-61. doi: 10.4103/0974-2069.58320.
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