Surgical repair of spontaneous dissection of PDA in a child
Dissection involving patent arterial duct (PDA) extending to main pulmonary artery (MPA) is an extremely rare condition. One such case has been reported in the European Heart Journal Case Reports.

The authors describe a case of complex dissection involving PDA extending to MPA, in a child with vein of Galen malformation. This was surgically corrected under deep hypothermic circulatory arrest, and the authors further describe the pathophysiology and surgical rationale in this report.

Learning points
• Spontaneous dissection of patent arterial duct (PDA) is extremely rare, and often seen with other pre-existing conditions or any traumatic interventions in children.

• Strong suspicion of infective endocarditis is important for clinical management of dissected PDA.

• Early surgery is important to help with the haemodynamic management of such a condition, and also to avoid catastrophic spontaneous rupture of either the pulmonary artery or the dilated duct.

• Deep hypothermic circulatory arrest is of vital use in such a situation, in order to allow for a bloodless field and for surgical exposure, thereby optimal surgical procedure is carried out.

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