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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A large patent ductus arteriosus in a patient with a giant pulmonary artery and congenital single coronary artery is a rare congenital cardiovascular malformation&#46; In this report&#44; we present images and videos of the percutaneous closure of an unusually large patent ductus arteriosus in a 33-year-old man with high pulmonary artery pressure&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">A 33-year-old man was diagnosed with a patent ductus arteriosus &#40;PDA&#41; shortly after birth&#44; but was then lost to follow-up&#46; He had no symptoms and received no medical treatment until he presented with a one-month history of progressive dyspnea and palpitations&#46; On physical examination he had a prominent left ventricular impulse with a loud continuous murmur&#46; There was no evidence of cyanosis&#44; clubbing&#44; or peripheral edema&#46; His chest X-ray showed cardiomegaly and enlargement of the left pulmonary hilum&#44; and an electrocardiogram revealed sinus tachycardia with incomplete right bundle branch block &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>A&#41;&#46; A transthoracic echocardiogram revealed a PDA with left-to-right shunt &#40;pulmonary&#47;systemic flow &#91;Qp&#47;Qs&#93; ratio of 1&#46;6&#41;&#44; left ventricular ejection fraction of 60&#37; and enlargement of the right heart chambers and the left pulmonary artery&#44; in addition to severe pulmonary hypertension&#46; Contrast computed tomography revealed a PDA &#40;approximately 16 mm in diameter at its narrowest portion&#41; connecting the aortic isthmus &#40;immediately distal and inferior to the left subclavian takeoff&#41; to the main pulmonary artery and coexistent with a giant left pulmonary artery &#40;80&#46;32 mm&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>B and C&#41;&#46; Coronary angiography showed a single coronary artery that originated from the right coronary artery &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>D and Videos 1 and 2&#41;&#46; During cardiac catheterization&#44; peak systolic pulmonary artery pressure was measured at 110 mmHg and pulmonary vascular resistance was 4&#46;8 Wood units&#46; Vasoreactivity testing with adenosine was negative&#46; A sizing balloon &#40;Amplatzer Sizing Balloon II&#44; St&#46; Jude Medical&#44; USA&#41;&#44; diameter 20 mm&#44; was used and the duct was measured at 17 mm in length by 6 mm in width at its narrowest diameter &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>E&#41;&#46; A fall in systolic pulmonary artery pressure of more than 30&#37; during balloon occlusion was our criterion for proceeding to transcatheter closure &#40;Video 3&#41;&#46; The PDA was subsequently successfully repaired using an 18 mm Amplatzer muscular ventricular septal defect occluder &#40;AMVSD&#41; &#40;St&#46; Jude Medical&#44; St&#46; Paul&#44; MN&#44; USA&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>F and Video 4&#41;&#46; A repeat echocardiogram after the procedure at one-year follow-up showed no evidence of residual shunting and progressive decreases in pulmonary artery diameter &#40;71 mm&#41; and right ventricular chamber diameters and pressures&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">In conclusion&#44; off-label use of the AMVSD may be considered for the occlusion of large PDAs in adult patients with high pulmonary artery pressure&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Ethical disclosures</span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Protection of human and animal subjects</span><p id="par0020" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Confidentiality of data</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the protocols of their work center on the publication of patient data&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Right to privacy and informed consent</span><p id="par0030" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article&#46;</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Financial support</span><p id="par0035" class="elsevierStylePara elsevierViewall">This research received no specific grant from any funding agency&#44; either commercial or not-for-profit&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conflicts of interest</span><p id="par0040" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
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Image in Cardiology
Percutaneous closure of an unusually large patent ductus arteriosus in a patient with a giant pulmonary artery and congenital single coronary artery
Encerramento percutâneo de canal arterial patente invulgarmente largo num doente com artéria pulmonar gigante e artéria coronária única
Bekir Serhat Yildiz
Corresponding author
bserhatyildiz@yahoo.com

Corresponding author.
, Yusuf Izzettin Alihanoglu, Ismail Dogu Kilic, Harun Evrengul
Department of Cardiology, Pamukkale University, Medical Faculty, Denizli, Turkey
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">&#40;A&#41; Chest X-ray showing cardiomegaly and enlargement of the left pulmonary hilum &#40;blue arrow&#41;&#59; &#40;B&#41; computed tomography &#40;CT&#41; image revealing a patent ductus arteriosus &#40;PDA&#41; in the frontal plane &#40;blue arrow&#41;&#59; &#40;C&#41; CT image showing a giant left pulmonary artery &#40;8&#46;32 cm&#41;&#59; &#40;D&#41; coronary angiography showing a single coronary artery originating from the right coronary artery&#59; &#40;E&#41; sizing balloon measuring the diameter of the PDA&#59; &#40;F&#41; the duct is occluded by an Amplatzer muscular ventricular septal defect occluder&#46;</p>"
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and an electrocardiogram revealed sinus tachycardia with incomplete right bundle branch block &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>A&#41;&#46; A transthoracic echocardiogram revealed a PDA with left-to-right shunt &#40;pulmonary&#47;systemic flow &#91;Qp&#47;Qs&#93; ratio of 1&#46;6&#41;&#44; left ventricular ejection fraction of 60&#37; and enlargement of the right heart chambers and the left pulmonary artery&#44; in addition to severe pulmonary hypertension&#46; Contrast computed tomography revealed a PDA &#40;approximately 16 mm in diameter at its narrowest portion&#41; connecting the aortic isthmus &#40;immediately distal and inferior to the left subclavian takeoff&#41; to the main pulmonary artery and coexistent with a giant left pulmonary artery &#40;80&#46;32 mm&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>B and C&#41;&#46; Coronary angiography showed a single coronary artery that originated from the right coronary artery &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>D and Videos 1 and 2&#41;&#46; During cardiac catheterization&#44; peak systolic pulmonary artery pressure was measured at 110 mmHg and pulmonary vascular resistance was 4&#46;8 Wood units&#46; Vasoreactivity testing with adenosine was negative&#46; A sizing balloon &#40;Amplatzer Sizing Balloon II&#44; St&#46; Jude Medical&#44; USA&#41;&#44; diameter 20 mm&#44; was used and the duct was measured at 17 mm in length by 6 mm in width at its narrowest diameter &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>E&#41;&#46; A fall in systolic pulmonary artery pressure of more than 30&#37; during balloon occlusion was our criterion for proceeding to transcatheter closure &#40;Video 3&#41;&#46; The PDA was subsequently successfully repaired using an 18 mm Amplatzer muscular ventricular septal defect occluder &#40;AMVSD&#41; &#40;St&#46; Jude Medical&#44; St&#46; Paul&#44; MN&#44; USA&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>F and Video 4&#41;&#46; A repeat echocardiogram after the procedure at one-year follow-up showed no evidence of residual shunting and progressive decreases in pulmonary artery diameter &#40;71 mm&#41; and right ventricular chamber diameters and pressures&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">In conclusion&#44; off-label use of the AMVSD may be considered for the occlusion of large PDAs in adult patients with high pulmonary artery pressure&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Ethical disclosures</span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Protection of human and animal subjects</span><p id="par0020" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Confidentiality of data</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the protocols of their work center on the publication of patient data&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Right to privacy and informed consent</span><p id="par0030" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article&#46;</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Financial support</span><p id="par0035" class="elsevierStylePara elsevierViewall">This research received no specific grant from any funding agency&#44; either commercial or not-for-profit&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conflicts of interest</span><p id="par0040" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
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Article information
ISSN: 21742049
Original language: English
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2023 August 20 8 28
2023 July 27 8 35
2023 June 25 8 33
2023 May 29 15 44
2023 April 16 3 19
2023 March 24 21 45
2023 February 18 15 33
2023 January 21 8 29
2022 December 17 17 34
2022 November 23 20 43
2022 October 26 19 45
2022 September 26 24 50
2022 August 23 29 52
2022 July 22 34 56
2022 June 19 17 36
2022 May 35 23 58
2022 April 17 24 41
2022 March 30 24 54
2022 February 32 16 48
2022 January 21 18 39
2021 December 17 29 46
2021 November 28 28 56
2021 October 19 40 59
2021 September 29 27 56
2021 August 20 33 53
2021 July 20 22 42
2021 June 22 23 45
2021 May 21 36 57
2021 April 65 14 79
2021 March 32 27 59
2021 February 36 17 53
2021 January 23 12 35
2020 December 40 14 54
2020 November 20 12 32
2020 October 28 13 41
2020 September 47 18 65
2020 August 12 5 17
2020 July 30 8 38
2020 June 37 11 48
2020 May 28 6 34
2020 April 38 11 49
2020 March 41 15 56
2020 February 41 12 53
2020 January 19 6 25
2019 December 34 8 42
2019 November 43 4 47
2019 October 27 5 32
2019 September 31 7 38
2019 August 26 6 32
2019 July 17 10 27
2019 June 33 10 43
2019 May 23 5 28
2019 April 27 12 39
2019 March 89 9 98
2019 February 94 8 102
2019 January 60 7 67
2018 December 30 12 42
2018 November 46 13 59
2018 October 62 22 84
2018 September 36 7 43
2018 August 26 7 33
2018 July 16 8 24
2018 June 18 4 22
2018 May 32 11 43
2018 April 29 10 39
2018 March 34 4 38
2018 February 19 5 24
2018 January 25 13 38
2017 December 28 7 35
2017 November 14 8 22
2017 October 21 12 33
2017 September 19 8 27
2017 August 24 10 34
2017 July 23 11 34
2017 June 29 6 35
2017 May 31 15 46
2017 April 13 7 20
2017 March 27 3 30
2017 February 29 2 31
2017 January 21 3 24
2016 December 31 5 36
2016 November 29 4 33
2016 October 19 4 23
2016 September 35 5 40
2016 August 23 1 24
2016 July 3 1 4
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Revista Portuguesa de Cardiologia (English edition)
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