First-Ever Surgical Treatment of Patent Ductus Arteriosus in an Adult Performed at St. Petersburg State University

For the first time in its history, the Center of Cardiac Surgery and Interventional Cardiology at St. Petersburg State University has successfully performed surgical treatment of patent ductus arteriosus (PDA) in an adult patient. This rare congenital heart defect, typically corrected in early childhood, required intervention in a 58-year-old woman.

For many years, the patient lived with the condition without knowing the true cause of her deteriorating health. The first alarming symptom was progressively worsening shortness of breath — initially during stair climbing and later even with minimal physical activity. Diagnostic evaluation revealed patent ductus arteriosus, a persistent abnormal connection between the aorta and the pulmonary artery. In adults, this condition is exceptionally rare, as the ductus normally closes spontaneously shortly after birth.

During a regional consultation, cardiovascular surgeon Alexey Vasilev recommended minimally invasive surgical treatment. Without intervention, the disease would have continued to progress, significantly increasing the risk of severe heart failure and disability.

“Patent ductus arteriosus places a dangerous overload on the heart. Oxygenated blood intended for systemic circulation is partially shunted back into the pulmonary artery, forcing the heart to pump the same volume repeatedly. Endovascular closure of the duct eliminates this pathological shunt and prevents the development of serious complications.”

– the specialist explained.

Based on multislice computed tomography data, an individually selected occluder was chosen for the patient. The procedure lasted less than one hour and was performed under local anesthesia. Through small punctures in the femoral artery and vein, surgeons delivered a mesh occlusion device into the duct. Once deployed, it completely sealed the abnormal connection between the aorta and the pulmonary artery.

Follow-up echocardiography performed two days later confirmed the success of the intervention, showing complete cessation of blood flow through the duct. The patient recovered well and was discharged home on the third postoperative day under cardiology supervision.

Note

Patent ductus arteriosus is a congenital heart defect essential for fetal circulation but normally closes shortly after birth. If it remains open, abnormal blood shunting leads to cardiac overload, pulmonary vascular damage, heart failure, and increased risk of bacterial endocarditis.

In full-term infants, the prevalence of PDA is only 0.01–0.03%. Without treatment, average life expectancy is approximately 40 years, with heart failure and infectious complications being the leading causes of death.

This rare adult procedure was made possible by the high level of expertise of the Center’s cardiac surgeons, as well as the availability of expert-class equipment and modern endovascular materials. The successful outcome demonstrates that even patients with rare and complex cardiovascular conditions can receive world-class care at St. Petersburg State University, restoring their ability to lead an active and fulfilling life.