Small residual patent ductus arteriosus after surgical ligation in young adult: to close or not to close - a dilemmatic case report

Percutaneous transcatheter closure has gained acceptance for patent ductus arteriosus (PDA) management ever since its introduction, including the management residual left-to-right shunts following surgical ligations. It is preferred than the more invasive surgical closure. While large PDA is closed to prevent heart failure, the decision to close a small hemodynamically insignificant PDA is still a debatable issue. We present a case of percutaneous transcatheter closure of small residual left-to-right shunt PDA using HeartR™ Lifetech PDA occluder with instantaneous closure in an asymptomatic adult patient. The justification of closure was made based on the previous history of infective endocarditis, followed by PDA ligation and endarterectomy surgery, at 1.5 year before admission.