Patent ductus venosus in an adult presenting as pulmonary hypertension, right-sided heart failure, and portosystemic encephalopathy.

Ductus venosus is a normal fetal structure connecting the portal and umbilical veins with the inferior vena cava, allowing a fraction of the umbilical vein blood to bypass the liver and reach the central circulation. Patent ductus venosus is the persistence of this embryonic portosystemic shunt. It is rarely seen in adults. Fewer than 20 cases of patent ductus venosus have been reported in the literature (1–13), presenting as portosystemic hepatic encephalopathy and hyperammonemia (1,2,4). We describe adult patent ductus venosus presenting not only with portosystemic encephalopathy, but also with pulmonary hypertension and right-sided heart failure.