title: Pulmonary artery closure in combination with patch technique for treating congenital heart disease combined with large patent ductus arteriosus: A clinical study of 9 cases.
abstract: OBJECTIVE
  To document clinical experience of treating congenital heart disease combined with large patent ductus arteriosus with pulmonary artery closure in combination with patch technique.
  
  
  METHODS
  Thirty-six patients (8 males and 28 females) who suffered from congenital heart disease and underwent hybrid surgery in the First Affiliated Hospital of Zhengzhou University from October 2010 to February 2014 were selected for this study. They aged 14 to 39 years and weighed 32.20 to 61.50 kg. Diameter of arterial duct was between 10 mm and 13 mm; 28 cases were tube type, 4 cases were funnel type and four cases were window type. All patients had moderate or severe pulmonary arterial hypertension; besides, there were 28 cases of ventricular septal defect, 16 cases of atrial septal defect, eight cases of aortic insufficiency, four cases of mitral stenosis and insufficiency and four cases of infectious endocarditis. Cardz Pulmonary Bypass (CPB) was established after chest was opened along the middle line. With the help of Transesophageal echocardiography, large patent ductus arteriosus was blocked off through pulmonary artery. Pulmonary artery was cut apart after blocking of heart. Large patent ductus arteriosus on the side of pulmonary artery was strengthened with autologous pericardial patch.
  
  
  RESULTS
  Of 36 patients, 32 patients had patent ductus arteriosus closure device and four patients had atrial septal defect closure device. Pulmonary arteries of 36 cases were all successfully closed. Systolic pressure declined after closure ((54.86±19.23) mmHg vs (96.05±23.07) mmHg, p<0.05); average pulmonary arterial pressure also declined after closure ((39.15±14.83) mmHg vs (72.88±15.76) mmHg, p<0.05). The patients were followed up for one to fifty one months (average 11.5 months). Compared to before surgery, left atrial diameter, left ventricular diameter and pulmonary artery diameter all narrowed after surgery. Besides, clinical symptoms were relieved and cardiac function of the patients also improved.
  
  
  CONCLUSIONS
  Hybrid surgery is feasible and safe in treating patients with large patent ductus arteriosus and congenital heart disease, which decreases surgical problems, shortens surgical time and lowers the incidence of complications.
authors.affiliation: Bing Wen, Department of Cardiovascular Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.
authors.forename: Bing
authors.initials: B
authors.lastname: Wen
authors.affiliation: Junya Yang, Department of Dermatological, the Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.
authors.forename: Junya
authors.initials: J
authors.lastname: Yang
authors.affiliation: Huiruo Liu, Department of Cardiovascular Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.
authors.forename: Huiruo
authors.initials: H
authors.lastname: Liu
authors.affiliation: Zhouyang Jiao, Department of Cardiovascular Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.
authors.forename: Zhouyang
authors.initials: Z
authors.lastname: Jiao
authors.affiliation: Wenzeng Zhao, Department of Cardiovascular Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.
authors.forename: Wenzeng
authors.initials: W
authors.lastname: Zhao
keywords: Hybrid surgery; Occlusion; Patent ductus arteriosus