Evidence map›Paper›PMID 40837243›Full record

ArticleFrontiers in cardiovascular medicine2025

Case Report: Non-reactive vasoreactivity testing in a patient with patent ductus arteriosus with pulmonary hypertension: is there still a way to turn things around?

Sisca Natalia Siagian, Elsa Hedia Panjaitan, Pandu Prasetyo Nugroho

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Article in Frontiers in cardiovascular medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Sisca Natalia SiagianDivision of Pediatric Cardiology and Congenital Heart Disease, Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Indonesia/National Cardiovascular Centre Harapan Kita, Jakarta, Indonesia.
Elsa Hedia PanjaitanFaculty of Medicine Universitas Indonesia, Jakarta, Indonesia.
Pandu Prasetyo NugrohoFaculty of Medicine Universitas Indonesia, Jakarta, Indonesia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Recent guidelines recommend patent ductus arteriosus (PDA) closure in adults based on hemodynamic criteria, such as pulmonary vascular resistance (PVR) and flow ratio (Qp:Qs). However, additional parameters like acute vasoreactivity testing (AVT) and closure testing, though lacking extensive data, may assist in identifying patients eligible for closure. We present the case of an adult patient with PDA and pulmonary hypertension (PH) whosuccessfully underwent transcatheter device closure guided by AVT and closure testing. Case presentation: A 35-year-old female presented with a two-year history of shortness of breath, cyanosis, and peripheral edema. She had been diagnosed with PDA at birth but did not undergo ligation due to parental refusal, leading to a 33-year loss of follow-up. Echocardiography revealed a bidirectional shunt through the PDA. Following cardiac catheterization (Qp:Qs 1.38, PVR: 21.5 WU) with AVT, the patient was diagnosed with PDA, PH with low flow, high resistance, and non-reactive to vasoreactivity test. She was prescribed sildenafil and discharged. After one year, the patient reported symptom improvement, with repeat catheterization showing a slight reduction in Qp:Qs (1.25) and PVR (16.38 WU), though values remained above the guideline cut-off for closure. However, the patient was then reactive to AVT, so we decided to perform device closure and observed the patient for 10 min before releasing the device. The patient was stable following the procedure and recovered well. One month later, the patient experienced significant symptom relief and could engage in moderate physical activity without discomfort. Conclusion: This case highlights the potential AVT, closure testing, and also the treat-and-repair strategy with sildenafil to expand the window of operability in adult PDA patients with PH. Further research especially on long-term outcomes, is recommended.

Indexed as

acute vasoreactivity testingclosure testpatent ductus arteriosuspercutaneous closurepulmonary hypertensionsildenafil

Identifiers

PMID40837243
PMCPMC12361252

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.