Operation for adult patent ductus arteriosus using cardiopulmonary bypass.
BACKGROUND
Surgical repair of adult patent ductus arteriosus is more hazardous than when performed on young patients.


METHODS
Nine adult patent ductus arteriosus patients underwent surgical repair between January 1986 and December 1998. There were 3 male and 6 female patients (mean age 55.0 years). The ratio of pulmonary blood flow to systemic flow was 2.40 +/- 0.95, and pulmonary arterial pressure was 56.0 +/- 26.4 mm Hg. The operation was performed using transpulmonary approach under total cardiopulmonary bypass. Balloon occlusion method was also utilized.


RESULTS
Direct closure was made in 5 and patch closure in 4 patients. Cardiopulmonary bypass and balloon occlusion were safely established. Cardioplegic arrest was not required in the 2 most recent patients. No operative death has occurred. Pulmonary arterial systolic pressure decreased to 35.3 +/- 6.6 mm Hg at 6 months after operation. The mean follow-up period for all patients is 55 months. To date, neither recannalization of the ductus nor pseudoaneurysm has been recognized.


CONCLUSIONS
Cardiopulmonary bypass with balloon occlusion provides a safe operation for adult patients with complicated patent ductus arteriosus.
Toda
R
R
Second Department of Surgery, Faculty of Medicine, Kagoshima University, and National Minami Kyushu Chuoh Hospital, Japan. toda@med6.kufm.kagoshima-u.ac.jp
Moriyama
Y
Y
Yamashita
M
M
Iguro
Y
Y
Matsumoto
H
H
Yotsumoto
G
G
D000328:Adult; D000368:Aged; D021721:Balloon Occlusion; D019917:Blood Vessel Prosthesis Implantation; D002315:Cardiopulmonary Bypass; D004374:Ductus Arteriosus, Patent / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006323:Heart Arrest; D006801:Humans; D008297:Male; D008875:Middle Aged; D015996:Survival Rate; D016896:Treatment Outcome