ArticleJACC. Case reports2026
Off-Label 16-mm VSD Occluder for Closure of a Giant PDA With Severe Pulmonary Hypertension.
Article in JACC. Case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Abstract
backgroundGiant patent ductus arteriosus (PDA) with pulmonary hypertension often presents unique challenges for closure, requiring extensive expert team discussion. CASE-SUMMARY: A 17-year-old girl with syncopal episodes, intermittent chest pain, and continuous cardiac murmur was diagnosed with a 12.5-mm PDA. After a few months of pulmonary vasodilator therapy, pulmonary vascular resistance (PVR) improved from 7 WU to 5.5 WU, and treatment with closure using a 16-mm ventricular septal defect (VSD) occluder proceeded. Post-procedure, symptoms resolved along with left ventricular remodeling. DISCUSSION: Off-label use of VSD occluders is increasing for treatment of large PDAs. In high-risk patients, careful hemodynamic assessment, trial occlusion, and staged pulmonary vasodilator therapy optimize outcomes. For controversial borderline PVR (5-8 WU), closure decisions should rely on comprehensive evaluation by adult congenital heart disease and pulmonary hypertension specialists rather than PVR alone. TAKE-HOME MESSAGES: Muscular VSD occluders provide a viable alternative for large PDA closure with complex anatomy. In borderline PVR (5-8 WU), decisions should rely on comprehensive evaluation by adult congenital heart disease and pulmonary hypertension specialists rather than PVR alone.
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