ISSN 2149-2263 | E-ISSN 2149-2271
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The Anatolian Journal of Cardiology Echocardiographic findings in patent ductus arteriosus-associated infective endarteritis: a case series and review of the literature [Anatol J Cardiol]
Anatol J Cardiol. Ahead of Print: AJC-36156

Echocardiographic findings in patent ductus arteriosus-associated infective endarteritis: a case series and review of the literature

Huitzilihuitl Saucedo-Orozco1, Jesus Vargas-Barron2, Clara A Vázquez-Antona3, Francisco Castillo-Castellon4
1Cardioneumology Department. Centro Médico Nacional La Raza. Instituto Mexicano Del Seguro Social, Seris y Zaachila. Col. La Raza. Azcapotzalco. Mexico City, 02990, México City
2Pharmacology Department. Instituto Nacional de Cardiología Ignacio Chávez, Juan Badiano No. 1, Col. Sección XVI, Tlalpan, Mexico City, 14080, México
3Pediatric Echocardiography Department. Instituto Nacional de Cardiología Ignacio Chávez, Juan Badiano No. 1, Col. Sección XVI, Tlalpan, Mexico City, 14080, México
4Tomography Department. Instituto Nacional de Cardiología Ignacio Chávez, Juan Badiano No. 1, Col. Sección XVI, Tlalpan, Mexico City, 14080, México

Background. Infectious endarteritis associated with patent ductus arteriosus (PDA-IE) is an uncommon complication in the era of antibiotics. However, it implies a clinical challenge in patients with a fever of undetermined origin; Two-dimensional transthoracic echocardiography (TTE) performs a fundamental role in diagnosis and follow-up.
Methods. A retrospective analysis was then made of the data of all patients admitted at our center with PDA-IE within 15 years, and a review of the literature regarding diagnosis, TTE findings, and treatment was performed.
Results. A total of 17 patients were identified. The mean age was 17.8 years. The TTE done in all patients confirmed the PDA and PA vegetations diagnosis; in five cases, one vegetation was present; in three cases, two vegetations were found, and in the nine remaining cases, three or more vegetations were observed. In two-thirds of the cases, the vegetations' size was 3 to 28 mm, and the principal morphology was filiform. In all cases, at least one of the vegetations was developed in the DA's lateral wall. Pulmonary valve (PV) was affected in 41% of the patients and caused low to moderate valvular regurgitation. Pulmonary embolism was present in 7 cases and pulmonary aneurism in one case.
Conclusions. Decreased incidence of PDA-IE has been currently achieved with early antibiotic therapy. However, today, this complication carries a significant risk of valve damage and other cardiac structures' involvement.

Keywords: Patent ductus arteriosus, Infectious endarteritis, Echocardiography, Congenital heart disease.



Corresponding Author: Huitzilihuitl Saucedo-Orozco, Mexico