[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-631055-105":59,"doc-detail-631055-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","treat-and-repair-therapy-for-giant-patent-ductus-arteriosus-complicated-with-pulmonary-embolism-letter-to-the-editor","“Treat and repair” therapy for giant patent ductus arteriosus complicated with pulmonary embolism - Letter to the Editor","","A case report discusses the rare combination of giant patent ductus arteriosus (PDA) with pulmonary embolism (PE), highlighting the resulting predisposition to pulmonary hypertension (PH) and progressive right heart overload. A 57-year-old woman with long-standing dyspnea and right heart failure manifestations was evaluated with echocardiography, CT angiography, and ventilation/perfusion scanning leading to a comprehensive diagnosis including PH, congenital PDA, heart valve disease, PE, and atrial fibrillation. After initial symptomatic management and anticoagulation, interventional treatment was performed using “treat and repair” strategies, achieving clinical improvement with reduced PE evidence and improved hemodynamic parameters.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/treat-and-repair-therapy-for-giant-patent-ductus-arteriosus-complicated-with-pulmonary-embolism-letter-to-the-editor/631055/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/treat-and-repair-therapy-for-giant-patent-ductus-arteriosus-complicated-with-pulmonary-embolism-letter-to-the-editor/631055.png","ImageObject",300,407,{"name":92,"@type":93},"Patrick","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-09","2026-10-22",true,{"@type":102,"interactionType":103,"userInteractionCount":19},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why is giant PDA complicated with pulmonary embolism considered especially challenging?","Question",{"text":112,"@type":113},"The combination can promote pulmonary hypertension, increasing right heart load and contributing to right heart failure, which raises the risk of misdiagnosis and difficult management.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How was PE identified and supported in the case?",{"text":117,"@type":113},"Ventilation/perfusion scanning showed perfusion-ventilation mismatch patterns consistent with PE, and subsequent repeat evaluations were used to judge improvement.",{"name":119,"@type":110,"acceptedAnswer":120},"What treatment strategy led to patient improvement?",{"text":121,"@type":113},"The patient received symptomatic therapy (including diuresis and cardiac support), anticoagulation, PH-targeted medication after discharge, and ultimately interventional treatment using “treat and repair” strategies, resulting in improved clinical status and reduced PE findings.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},631055,1793102941,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":19,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":24,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144,"preview_page_count":4},549758146520,"https://ap-avatar.wpscdn.com/avatar/80002397d8c0411e94?_k=1775819394049821470","Journal of Geriatric Cardiology  \nLETTER TO THE EDITOR J Geriatr Cardiol 2023; 20(12): 890–894  \n“Treat and repair”therapy for giant patent ductus arteriosus complicated with pulmonary embolism  \nJian-Ming WANG, Li-Li MENG, Jia-Wang XIAO, Zhong-Chao WANG, Jing-Song GENG, Qi-Guang WANG✉  \nDepartment of Congenital Heart Disease, General Hospital of Northern Theater Command, Shenyang, China  \n✉ [Correspondence to:](Correspondence to: wqg1993@163.com)[ wqg1993@163.com](Correspondence to: wqg1993@163.com)  \n[https://doi.org/10.26599/1671-5411.2023.12.007](https://doi.org/10.26599/1671-5411.2023.12.007)  \natent ductus arteriosus (PDA) is one of the mo  \nPst cform–coongef connitagelheanitatheafertctsdi,saecacsoeusn[1t]inItgs  \ncombination with pulmonary embolism (PE) is extremely rare, and there are few relevant reports. Especially giant PDA complicated with PE is prone topulmonary hypertension (PH), which will significantly increase the right heart load, right ventricle hypertrophy, and result in clinical escape diagnosis or misdiagnosis. The adult patients with giant PDA often had the hemodynamic status of the Eisenmenger syndrome, which was once considered to be a surgical or interventional treatment contraindication.[2] If combined with PE, it would further lead to increased pulmonary vascular resistance and right heart failure, with high disability and mortality, which could make management extremely difficult.[3] With the advent of PH targeted drugs and the progress of standardized diagnosis and treatment of PE, we reported a case of patient with giant PDA complicated with PE who successfully received interventional treatment following “treat and repair” strategies.  \nA 57-year-old woman complained of chest tightness and shortness of breath after activity for more than ten years, and aggravated her condition accompanied by abdominal distension, lower limb edema, awakening at night and dyspnea, and decreased activity tolerance for more than ten days. Her blood pressure was 127/62 mmHg and heart rate was 110 beats/min. On examination, thick respiratory sounds on auscultation in both lungs, and slight moist rales can be heard on both lungs. Cardiovascular physical examination revealed the heart boundary expands to the lower left with grade 1/6 systolic murmur along the 2nd to 3rd ribs at the left edge of sternum, 2/6 grade systolic murmur was detected at auscultation  \narea of tricuspid valve, and the pulmonary valve second sound was slightly stronger, with peripheral vascular sign, severe edema in both lower limbs, and peripheral venous pressure of 24 cm H2O. There was no jugular venous distention. Echocardiography from local hospital showed bicuspid aortic valve with severe aortic regurgitation.  \nLaboratory examination showed N-terminal pro-B-type natriuretic peptide (NT-proBNP) was 5091 pg/mL, cardiac troponin T was 10 ng/L and the D-dimer was 0.63 mg/L. The upper limb oxygen saturation was 92%, whereas lower limb oxygen saturation was 88%. The screening of rheumatic, immune, and connective tissue disease was negative. The results of tumor markers test for female were negative. The electrocardiogram showed atrial fibrillation. The transthoracic echocardiography (TTE) revealed that PDA (1.5 cm) with PH (systolic pulmonary artery pressure: 113 mmHg), mild aortic stenosis and mild to moderate aortic regurgitation, mild mitral regurgitation, and mild to moderate pulmonary valve regurgitation. The tricuspid annular plane systolic excursion (TAPSE) was 14 mm, and the ratio of the right to left ventricular diameters (RV/LV) was 33/40. The computed tomography (CT) angiography showed that the PDA, and aortic stenosis with valve neoplasm formation tobe excluded (Figure 1) . Chest CT showed interstitial changes and multiple old lesions in both lungs, PH, and a small amount of pericardial effusion. The pulmonary ventilation/perfusion scan result was highly possible of PE (the area where the ventilation/blood flow perfusion mismatch decrea","cbCairAvxPkGJvUK","https://ap.wps.com/l/cbCairAvxPkGJvUK","pdf",2996835,"English","# Case background and rationale\n## Rare association of giant PDA and PE with PH\n# Patient presentation and evaluation\n## Symptoms, exam findings, and baseline tests\n## Echocardiography, CT angiography, and ventilation/perfusion scanning\n# Diagnosis and initial management\n## Differential exclusion and final diagnostic set\n## Symptomatic therapy and anticoagulation\n# Follow-up and treatment outcome","[{\"question\":\"Why is giant PDA complicated with pulmonary embolism considered especially challenging?\",\"answer\":\"The combination can promote pulmonary hypertension, increasing right heart load and contributing to right heart failure, which raises the risk of misdiagnosis and difficult management.\"},{\"question\":\"How was PE identified and supported in the case?\",\"answer\":\"Ventilation/perfusion scanning showed perfusion-ventilation mismatch patterns consistent with PE, and subsequent repeat evaluations were used to judge improvement.\"},{\"question\":\"What treatment strategy led to patient improvement?\",\"answer\":\"The patient received symptomatic therapy (including diuresis and cardiac support), anticoagulation, PH-targeted medication after discharge, and ultimately interventional treatment using “treat and repair” strategies, resulting in improved clinical status and reduced PE findings.\"}]","“Treat and repair” therapy for giant patent ductus arteriosus complicated with pulmonary embolism - Letter to the Editor | PDF",1792668616,13]