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Blok, I.M., Van Riel, A.C., Van Dijk, A.P., Mulder, B.J. and Bouma, B.J. (2017) From Bosentan to Macitentan for Pulmonary Arterial Hypertension and Adult Congenital Heart Disease: Further Improvement? International Journal of Cardiology, 227, 51-52.
https://doi.org/10.1016/j.ijcard.2016.11.211

has been cited by the following article:

• TITLE: Isolated Patent Ductus Arteriosus in an Elderly Female, Aged 65 Years—A Case Report

  AUTHORS: Ramachandran Muthiah

  KEYWORDS: Adult Ductus, Pulmonary Hypertension, Pulmonary Vasodilators, Transcatheter Closure, Wright Technique

  JOURNAL NAME: Case Reports in Clinical Medicine, Vol.7 No.5, May 28, 2018

  ABSTRACT: Aim: To report a case of longer-lived patent ductus arteriosus with features of pulmonary arterial hypertension up to the age of 65 years in an elderly woman. Introduction: The clinical recognition of patent ductus arteriosus with severe pulmonary hypertension is difficult. Only 60% of adults presented with a continuous murmur in a recent series. Asymptomatic patent ductus arteriosus tolerated for many years and may not require closure. Case Report: A 65 years old female presented with dyspnea had signs of pulmonary arterial hypertension with enlarged pulmonary artery and its branches, atrial fibrillation along with a continuous murmur in the left second intercostal space. Echocardiography revealed a 13 mm size patent ductus arteriosus and a bidirectional with predominant left-to-right shunt. Patient was managed conservatively and symptoms got improved with medical therapy. Conclusion: Treatment of patent ductus arteriosus in the setting of pulmonary hypertension is challenging. Early repair can mitigate the development of pulmonary hypertension and reverse vasculopathy in more advanced disease. Maternal aspirin ingestion should be avoided in pregnancy since it causes constriction of fetal ductus.