Pulmonary and aortic endarteritis revealing a patent ductus arteriosus in an adult

Abstract

The ductus arteriosus, an essential fetal structure, normally closes spontaneously soon after birth. Its persistence into late adulthood is considered to be rare; infective endarteritis (IE) complicating a patent ductus arteriosus (PDA) is an even rarer event. The clinical picture of an infected PDA could be subtle, and the diagnosis is frequently delayed. We present the case of a young woman who presented with prolonged fever for whom we made the diagnosis of a PDA complicated by IE, with vegetations in both pulmonary and aortic walls with mycotic aneurysms of the descending aorta. She underwent surgery and the post-operative course was uneventful. To our knowledge, this is the first reported case of a PDA complicated with both pulmonary and aortic endarteritis.

Transcatheter Closure of a Patent Ductus Arteriosus with Healed Vegetation: A Case Report

“…In most case reports on PDAs complicated by IE, the vegetations involved the pulmonary artery or the pulmonary valve and were resolved by surgical resection or antibiotics [10][11][12] . In one case report of a young woman with PDA complicated by IE, the vegetations were in both the pulmonary and the aortic walls with mycotic aneurysms of the descending aorta that were resolved by surgery [13] . In our patient, the vegetation was seated inside the PDA, this rare position could be explained by the presence of a constriction in the distal end of the PDA at its entry into the pulmonary artery as a trial of duct closure, that prohibited the vegetation to pass to the pulmonary artery side.…”

“…In most previously recorded patients with PDAs complicated with IE, the vegetations did not resolve with antibiotics and required surgical excision of the vegetation with concomitant PDA closure [8,9,13] . To our knowledge, this is the first reported case of a PDA that was previously complicated with IE in which the healed vegetation was seated within the duct and was successfully occluded by transcatheter closure using a 5x4 mm Nit-Occlud® PDA coil (PFM medical, Köln, Germany).…”