title: The current role of surgery in treating adult patients with patent ductus arteriosus.
abstract: OBJECTIVE
  Surgical closure of patent ductus arteriosus (PDA) is still required in selected adult patients. We analyzed the morphology of the anomaly and coexisting pathological findings in adult patients who were recently referred to our institute for surgical PDA repair.
  
  
  METHODS
  Six adult PDA patients who were not considered candidates for percutaneous closure underwent surgical PDA correction. In three patients with isolated PDA, computed tomographic scan revealed short, wide, and distorted ductus. In the remainder three patients, concomitant heart or aortic disease was found. Transpulmonary approach under total cardiopulmonary bypass or hypothermic circulatory arrest was performed.
  
  
  RESULTS
  In all patients, a Dacron patch was used to close the duct. The balloon occlusion technique with normothermic cardiopulmonary bypass was performed in four patients. In one of these patients, the balloon occlusion was not feasible because of unfavorable ductal anatomy, and PDA was closed in short hypothermic circulatory arrest. In two patients with aortic aneurysm, PDA closure and aortic reconstruction were performed in deep hypothermic circulatory arrest. No significant complications occurred during postoperative course. After the mean follow-up period of 48 months, neither ductal reopening nor aneurysmal degeneration of remnant ductal tissue was found.
  
  
  CONCLUSIONS
  Surgical PDA closure in adults remains the treatment of choice in wide, deformed PDAs unsuitable for percutaneous closure and PDAs associated with surgical aortic or heart disease.
authors: Department of Cardiac surgery, Dedinje Cardiovascular Institute, Belgrade, Serbia.
authors: Bosko P
authors: BP
authors: Djukanovic
authors: Slobodan
authors: S
authors: Micovic
authors: Ivan
authors: I
authors: Stojanovic
authors: Dragana
authors: D
authors: Unic-Stojanovic
authors: Sinisa
authors: S
authors: Birovljev
authors: Petar M
authors: PM
authors: Vukovic
mesh_terms: D000328:Adult; D000367:Age Factors; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass; D004374:Ductus Arteriosus, Patent / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006324:Heart Arrest, Induced; D006801:Humans; D007036:Hypothermia, Induced; D008297:Male; D008875:Middle Aged; D055771:Serbia; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult
keywords: Congenital Heart Disease; Patent Ductus Arteriosus; Surgery