Abstract
Patent ductus arteriosus (PDA) is a congenital heart disease occasionally encountered in adult cardiology, which can potentially be complicated by endocarditis or progressive left ventricular (LV) volume overload. Although transcatheter device closure has become a standard treatment in most cases, it can sometimes be challenged by anatomical variation of PDA. We report a case of 53-year-old man with PDA which was successfully treated by percutaneous closure, which had failed 12 years ago because of guidewire passage failure. Transesophageal echocardiography played an important role to give precise anatomical information and enable us to apply an alternative retrograde approach. Closure of PDA resulted in the resolution of symptom and decrease in LV size and volume.