Abstract
A 3-year-old male child was diagnosed with patent ductus arteriosus. The evaluation of this patient by computed tomography (CT) angiography revealed a big tortuous patent ductus arteriosus and proximal left pulmonary artery stenosis. Successful elective surgical repair was undertaken.
Keywords
A clinical diagnosis of patent ductus arteriosus was made in a 3-year-old male child. Echocardiography confirmed the presence of a large patent ductus and also suggested the presence of significant stenosis of the proximal left pulmonary artery. Hence, he underwent computed tomography (CT) angiography to define the anatomy. This revealed a wide and tortuous patent ductus arteriosus as well as proximal left pulmonary artery stenosis (Figures 1 and 2 ). Catheter interventions to close the ductus and to address the relatively long segment of pulmonary arterial narrowing were considered, but a surgical repair was ultimately chosen. Through a median sternotomy approach, the duct was divided and both the ends were oversewn. Minimum diameter of the left pulmonary artery was 3 mm. The distal arterial segment, at the level of the origin of the upper lobe artery, appeared normal. The length of the hypoplastic segment was 15 mm. On cardiopulmonary bypass, the left pulmonary artery was opened anteriorly and augmented with a patch of autologous pericardium which had been treated with glutaraldehyde. Recovery was uneventful and postoperative echocardiography showed no obstruction in flow to the left lung. The possibility of preexisting left pulmonary artery stenosis must be considered before cardiac catheterization and device occlusion of patent ductus arteriosus is undertaken. 1 Computed tomography angiography provides excellent definition of anatomic details. Surgical repair should be considered, and may be preferable, depending upon the age of the patient and the degree and length of the pulmonary artery stenosis.
Computed tomography angiography demonstrating the large tortuous patent ductus arteriosus with proximal left pulmonary artery hypoplasia.
Computed tomography angiography demonstrated a large tortuous patent ductus arteriosus with hypoplasia of the proximal left pulmonary artery.
Footnotes
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
The author(s) received no financial support for the research, authorship, and/or publication of this article.