日本小児循環器学会雑誌 Pediatric Cardiology and Cardiac Surgery

A ductus arteriosus aneurysm (DAA) involves cystic or tubular dilatation of the persistent ductus arteriosus and can lead to life-threatening complications, including aneurysm rupture, thromboembolism, and infection. We report the case of a 56-year-old man who underwent percutaneous DAA closure. The patient was diagnosed with DAA following computed tomography (CT) scans after an abnormal finding on a routine chest radiography examination. CT imaging revealed an aneurysm with a maximum diameter of 39 mm, an aortic side diameter of 5.6 mm, and a pulmonary side diameter of 2.2 mm. The patient did not have any symptoms, such as dysphagia and hoarseness. Although surgical correction and stent graft implantation were considered, a minimally invasive percutaneous approach was chosen. A guidewire was introduced from the aortic side and retrieved with a snare catheter from the pulmonary artery (PA) side, creating a wire-loop. A delivery sheath was inserted from the PA side, and the aortic side of the DAA (measuring 5.6 mm) was percutaneously closed using a 12 mm/10 mm Amplatzer™ Duct Occluder (ADO). Follow-up CT conducted three months later confirmed near-complete thrombosis of the aneurysm. This case demonstrates that percutaneous closure of large DAAs in adults using devices such as the ADO is a safe, effective, and minimally invasive treatment option.