Endovascular surgery using an original occluder for patent ductus arteriosus in an adult patient.

The patient was a 67-year-old woman in whom patent ductus arteriosus was diagnosed in childhood but not treated. In April 2000, she was hospitalized for exacerbation of heart failure. Marked restrictive impairment was seen: %VC was 36.1%, and FEV1% was 77.0% (respiratory function tests). As calcification was present, and since the aortic opening measured 20 mm, coil occlusion or thoracoscopic surgical interruption were considered difficult to perform. Because of concerns about postoperative respiratory complications associated with thoracotomy, the ductus was occluded under local anesthesia using an original occluder consisting of a vascular graft and modified Z-stent. Postoperatively, during more than three years of follow-up, the patient has remained well with no residual shunt or occluder migration. Consequently, patent ductus arteriosus occlusion using an original occluder appears to be a superior, minimally invasive technique that can successfully treat large ductus arteriosus complicated by calcification.