Calcification of patent ductus arteriosus

Feature of PDA calcification on X-ray chest

Abstract: Feature of PDA calcification on X-ray chest: Calcified patent ductus arteriosus (PDA) produces an inverted Y shaped pattern of calcification on x-ray chest PA view.

Detection of calcification of the patent ductus arteriosus is important because of potential problems with surgical management. The simple surgery for closure of patent ductus arteriosus was triple ligation which was a closed heart procedure not requiring cardiopulmonary bypass. But a calcified ductus cannot be dealt with by this procedure. The general dictum is that a calcified ductus needs division and ligation with support of cardiopulmonary bypass. This is more likely to be needed in adult patients. Now device closure is being undertaken even in cases of calcified ductus. Of the twenty one adult patients reported by Bonhoeffer P and associates, the ductus was calcified in seven patients.¹

Calcification of a patent ductus arteriosus has been reported by several authors in relatively young patients.^2,3,4 Calcification of an obliterated ductus arteriosus or ligamentum arteriosus can also occur. This may be noted as an incidental finding on computed tomographic imaging of the thorax.⁵

X-ray appearance of calcification of patent ductus arteriosus

Typical appearance of calcification of patent ductus arteriosus in an X-ray chest PA view is inverted Y shaped. Inverted Y shape is a combined appearance of calcification of the aortic arch extending down to the pulmonary artery and patent ductus arteriosus. Calcification of patent ductus arteriosus on X-ray was first reported by Edward Weiss.⁶

Calcification of patent ductus arteriosus detected by echocardiography

Detection of calcification of a patent ductus arteriosus by echocardiography has also been reported.⁷

References

1. Bonhoeffer P, Borghi A, Onorato E, Carminati M. Transfemoral closure of patent ductus arteriosus in adult patients. Int J Cardiol. 1993 Jun;39(3):181-6.
2. Ruskin H, Samuel E. Calcification in the patent ductus arteriosus. Br J Radiol. 1950 Dec;23(276):710-7.
3. Furuse A, Mizuno A, Nohara F, Ito K, Saigusa M. Calcified patent ductus arteriosus. Jpn Heart J. 1968 May;9(3):316-20.
4. Pochaczevsky R, Dunst ME. Coexistent pulmonary artery and aortic arch calcification. Its significance and association with patent ductus arteriosus. Am J Roentgenol Radium Ther Nucl Med. 1972 Sep;116(1):141-5.
5. Charles S. White, Linda B. Haramati, Joseph Jen-Sho Chen, Jeffrey M. Levsk. In Cardiac Imaging. Oxford University Press. Fig. 29.6.
6. Weiss E. Calcified plaque of the aorta at the entrance of a patent ductus arteriosus: A point in diagnosis. Am Heart J. 1931 Oct;7(1):114–115.
7. Vargas-Barron J, Sanches-Ugarte T, Keirns C, González-Medina A, Vázquez-Sanches J. Calcification of patent ductus arteriosus detected by two-dimensional echocardiography. Am Heart J. 1987 Aug;114(2):446-8.