Patent ductus arteriosus PDA is a rare diagnosis in adults, since symptoms and signs usually occur in infancy and most cases are treated shortly after diagnosis. We present two patients who were first diagnosed with PDA during adulthood. In the second case the sequelae of the PDA are less clear. In both patients, closure of the PDA surgically in one case, percutaneously in the other was successful. It can be associated with other cardiovascular anomalies, most importantly coarctation of the aorta, ventricular septal defect and aortic or pulmonary stenosis. PDA is most often diagnosed and surgically or percutaneously corrected in infancy, so a primary diagnosis is rare in adulthood.

Patent ductus arteriosus PDA is a congenital heart defect — a structural heart problem that is present at birth. Patent ductus arteriosus is an abnormal connection between the aorta and the pulmonary artery in the heart. While the baby is in the womb, the aorta and the pulmonary artery are connected by a temporary blood vessel, the ductus arteriosus, as part of the normal fetal circulation. The ductus arteriosus streamlines fetal circulation by flowing blood directly to the aorta, bypassing the lungs. After birth, the ductus arteriosus usually seals off so that blood from these two vessels does not mix.

Large PDAs are rarely discovered in the adult patient. If present, they are often associated with high pulmonary blood pressures and pulmonary vascular obstructive disease PVOD , which may be the result of the left to right shunt the movement of blood from the aorta into the pulmonary artery through the open ductus PDA. Diagnosis of a small PDA is often difficult because of the lack of major symptoms. However, there will usually be a murmur, though often a mild one, and the patient may experience no symptoms.

An unclosed hole in the aorta. Before a baby is born, the fetus's blood does not need to go to the lungs to get oxygenated. The ductus arteriosus is a hole that allows the blood to skip the circulation to the lungs. However, when the baby is born, the blood must receive oxygen in the lungs and this hole is supposed to close. If the ductus arteriosus is still open or patent the blood may skip this necessary step of circulation.