Soliman Mosaad, Mowaphy Khaled, Elsaadany Nshaat A, Soliman Reem
Department of Vascular Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
J Vasc Surg Cases Innov Tech. 2020 Nov 6;7(1):56-60. doi: 10.1016/j.jvscit.2020.10.016. eCollection 2021 Mar.
Patients with a large patent ductus arteriosus (PDA) can have several presentations. Many will be asymptomatic, some could develop severe pulmonary hypertension, and others can develop Eisenmenger syndrome. We have presented a case in which a PDA correction device was embolized to the abdominal aorta, 2 months after transcatheter closure of a large PDA. The patient presented with an acute abdomen. In the management of the case, we implemented a hybrid technique in the process of device retrieval. Transbrachial access and a lower abdominal midline incision were accomplished to dislodge the device from the supraceliac aorta to the aortic bifurcation. The Amplatzer Ductal Occluder (St Jude Medical Inc, St Paul, Minn) was extracted through a small arteriotomy of the distal abdominal aorta. The procedure was followed by a dramatic improvement of the ischemic liver and bowel, evidenced by the vanishing of the cyanotic hue of the liver and normalization of the bluish discoloration of the intestine.
患有大型动脉导管未闭（PDA）的患者可能有多种表现。许多患者无症状，一些患者可能发展为严重的肺动脉高压，还有一些患者可能发展为艾森曼格综合征。我们报告了一例在大型PDA经导管封堵术后2个月，PDA封堵装置栓塞至腹主动脉的病例。患者表现为急腹症。在该病例的处理中，我们在取出装置的过程中采用了杂交技术。通过经肱动脉途径并在下腹部正中做切口，将装置从腹腔干上方的主动脉移至主动脉分叉处。通过腹主动脉远端的小动脉切口取出了Amplatzer动脉导管封堵器（圣犹达医疗公司，明尼苏达州圣保罗）。该操作之后，缺血的肝脏和肠道有了显著改善，表现为肝脏的青紫颜色消失以及肠道的蓝色变色恢复正常。
