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. 2013;4(5):483-5.
doi: 10.1016/j.ijscr.2013.02.011. Epub 2013 Feb 26.

A rare complication of pre-Eisenmenger patent ductus arteriosus: Pulmonary artery dissection

Yasin Ay  1 , Nuray Kahraman Ay, Cemalettin Aydin, Ibrahim Kara, Rahmi Zeybek
Affiliations

A rare complication of pre-Eisenmenger patent ductus arteriosus: Pulmonary artery dissection

Yasin Ay et al. Int J Surg Case Rep. 2013.

Abstract

Introduction: Pulmonary artery dissection associated with patent ductus arteriosus is usually seen in patients with pulmonary hypertension and Eisenmenger's syndrome. This paper presents a case with pre-Eisenmenger patent ductus arteriosus complicated by pulmonary artery dissection, and explains how she was surgically treated.

Presentation of case: The transthoracic echocardiography of a 21-year-old woman complaining of effort dyspnea revealed patent ductus arteriosus. Contrast-enhanced thoracic computed tomography scan showed patent ductus arteriosus and dissection in the main pulmonary artery extending from the edge of the patent ductus arteriosus orifice to the pulmonary valve. The patent ductus arteriosus was divided with pledgeted prolene suture and the dissected aneurysmal portion of the pulmonary artery was resected by surgery. Dacron graft interposition was applied to the main pulmonary artery.

Discussion: Because rupture causes cardiogenic shock and sudden death, diagnosis is rare in the living subject and pulmonary artery dissection is frequently detected in autopsy. A case with pulmonary artery dissection as a result of patent ductus arteriosus has been reported in the literature, but the patient died in the preoperative period. In our study, the patient was not diagnosed to have Eisenmenger's syndrome, but had pulmonary artery dissection, a complication arising from patent ductus arteriosus. The patient underwent curative surgery that included pulmonary artery dissection repair and closure of the patent ductus arteriosus.

Conclusion: In addition to pulmonary artery aneurysm, pulmonary artery dissection must also be considered as a complication in cases of patent ductus arteriosus with high pulmonary artery pressure diagnosed in adulthood.

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Figures

Fig. 1
Fig. 1
Pulmonary artery dissection beginning from the edge of the PDA.
Fig. 2
Fig. 2
Pulmonary artery dissection.
Fig. 3
Fig. 3
Operative view of pulmonary artery dissection.
Fig. 4
Fig. 4
Graft interposition to pulmonary artery.
Fig. 5
Fig. 5
Postoperative CT view of pulmonary artery.
See this image and copyright information in PMC

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