A Challenging Late Transcatheter Patent Ductus Arteriosus (PDA) Closure in Pediatric Populations: A Case Report

The treatment of Patent Ductus Arteriosus (PDA) in adults and adolescents can be challenging. However, percutaneous transcatheter closure has been proven to be a safe and effective approach in these populations. Devices, such as the Amplatzer Duct Occluder, are routinely used despite the limited number of related studies. This study aims to analyze the success of transcatheter PDA closure and post-procedure follow-up in two case reports. We also review our experience with this technique.

We managed two patients with large PDA: one was a newly diagnosed case presenting with chest pain and dyspnea with normal pulmonary pressure (12/7 mmHg), while the other one was a chronic case with Eisenmenger syndrome that had been medically managed for years as it was inoperable. This patient was recently admitted to our department with palpitations and hyperdynamic heart, showing subsystemic pulmonary artery pressure (91/53 mmHg).

The successful transcatheter closure of a significant PDA in such cases may effectively eliminate the dangerous combination of large PDA shunt and pulmonary hypertension in this high-mortality, high-morbidity risk population.

Immediate post-closure pulmonary artery pressure measurements, performed using specialized devices (8-10mm Lifetech and 12mm VSD muscular Memoporr), showed no residual PDA. Serial follow-up examinations demonstrated complete resolution of symptoms. Thus, while PDA progression varies between cases, each patient requires individualized evaluation and management.

Transcatheter PDA closure (TCPC) in adults presents technical challenges; however, both patients in our series successfully underwent the procedure without complications and demonstrated sustained reductions in pulmonary artery pressure during follow-up monitoring.