A Case of Asymptomatic Severe Pulmonary Valve Stenosis with Patent Foramen Ovale and Patent Ductus Arteriosus in an Adult

Seon A Kim, Sung-Ho Her, Mahn Won Park, Soo Jin Na, Hyung Duk Kim, Ji Eun Kim, Woo Hyeon Kim
2013 Korean Journal of Medicine  
Pulmonary valve stenosis (PS) is the 3rd most common form of adult congenital heart disease. The patient was a 56-year-old woman, with known congenital heart disease but who was not receiving any treatment as she was not functionally limited. A two-dimensional echocardiogram showed severe right ventricular hypertrophy, pulmonary valve thickening and systolic doming. A color Doppler revealed a retrograde flow from the aorta to the left pulmonary artery. She had severe heart failure on the right
more » ... and side from a PS but did not display any symptoms. We hypothesized that she had a retrograde flow to the pulmonary circulation through a patent ductus arteriosus (PDA), through which oxygenated blood could be supplied to the systemic circulation and, hence, no hypoxia. We attempted a balloon valvuloplasty for the PS followed by a device closure for the PDA. Here we report on this adult female with severe PS but lacking any symptoms, due to the presence of a PDA. ( Korean J Med 2013;85:406-410) Keywords: Pulmonary valve Stenosis; Patent foramen ovale; Patent ductus arteriosus 서 론 폐동맥판협착은 소아 선천성 심질환의 10%를 차지하며[1] 대부분은 단독으로 나타나지만 팔로4징, 폐동맥협착증, 총동 맥간증 등이 복합된 중증 선천성 심질환 형태로 나타나기도 한다. 질병은 양성 경과를 보이며 대부분은 성인까지 생존하 지만 정기적인 검진이 필요하며 중증의 폐동맥판협착은 우 심실부전에 의한 증상을 동반하게 되고 중재적 시술이나 수 술적 치료를 필요로 한다. 폐동맥협착증과 난원공개존증이 동반된 증례에서 중재적 시술을 통해 성인기까지 생존한 경 우는 있으나 동맥관개존증이 동반되어 성인까지 무증상으로 중재적 시술이나 수술적 치료 없이 생존한 경우는 아직 보
doi:10.3904/kjm.2013.85.4.406 fatcat:hsfeajkiifhy7lqgb6etksrtbq