title: A rare complication of pre-Eisenmenger patent ductus arteriosus: Pulmonary artery dissection.
abstract: BACKGROUND
  Pulmonary artery dissection associated with patent ductus arteriosus is usually seen in patients with pulmonary hypertension and Eisenmenger's syndrome. This paper presents a case with pre-Eisenmenger patent ductus arteriosus complicated by pulmonary artery dissection, and explains how she was surgically treated.
  
  
  METHODS
  The transthoracic echocardiography of a 21-year-old woman complaining of effort dyspnea revealed patent ductus arteriosus. Contrast-enhanced thoracic computed tomography scan showed patent ductus arteriosus and dissection in the main pulmonary artery extending from the edge of the patent ductus arteriosus orifice to the pulmonary valve. The patent ductus arteriosus was divided with pledgeted prolene suture and the dissected aneurysmal portion of the pulmonary artery was resected by surgery. Dacron graft interposition was applied to the main pulmonary artery.
  
  
  CONCLUSIONS
  Because rupture causes cardiogenic shock and sudden death, diagnosis is rare in the living subject and pulmonary artery dissection is frequently detected in autopsy. A case with pulmonary artery dissection as a result of patent ductus arteriosus has been reported in the literature, but the patient died in the preoperative period. In our study, the patient was not diagnosed to have Eisenmenger's syndrome, but had pulmonary artery dissection, a complication arising from patent ductus arteriosus. The patient underwent curative surgery that included pulmonary artery dissection repair and closure of the patent ductus arteriosus.
  
  
  CONCLUSIONS
  In addition to pulmonary artery aneurysm, pulmonary artery dissection must also be considered as a complication in cases of patent ductus arteriosus with high pulmonary artery pressure diagnosed in adulthood.
authors.affiliation: Department of Cardiovascular Surgery, Bezmialem Vakif University, 34093 Fatih, Istanbul, Turkey. Electronic address: yasinay.78@hotmail.com.
authors.forename: Yasin
authors.initials: Y
authors.lastname: Ay
authors.forename: Nuray Kahraman
authors.initials: NK
authors.lastname: Ay
authors.forename: Cemalettin
authors.initials: C
authors.lastname: Aydin
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Kara
authors.forename: Rahmi
authors.initials: R
authors.lastname: Zeybek
references.citation: Heart. 2005 Feb;91(2):142-5
references.pmid: 15657218
references.citation: Eur J Echocardiogr. 2010 Sep;11(8):E32
references.pmid: 20421228
references.citation: Eur J Cardiothorac Surg. 2010 Dec;38(6):805
references.pmid: 20478716
references.citation: N Engl J Med. 2007 May 17;356(20):2110-2
references.pmid: 17507716
references.citation: J Comput Assist Tomogr. 2000 Jan-Feb;24(1):92-5
references.pmid: 10667667