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Closure of calcified patent ductus arteriosus
S Tsukamoto1, S Shindo, M Obana
1Department of Cardiovascular Surgery, National Hospital Tokyo Disaster Medical Center, 3256 Midori-cho, Tachikawa-shi, Tokyo 190-0014, USA.
Insights
Surgical closure of patent ductus arteriosus (PDA) in adults with calcification and pulmonary hypertension can be achieved without circulatory arrest. This technique uses a transpulmonary balloon catheter and Nélaton
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Medical Device Innovation
Background:
- Patent ductus arteriosus (PDA) in adults can present with complex features like calcification and pulmonary hypertension.
- Traditional surgical approaches often necessitate cardiopulmonary bypass and circulatory arrest.
Observation:
- A novel technique for PDA closure in adults is described.
- This method utilizes an anterior median sternotomy approach with cardiopulmonary bypass.
- Sutures are placed without requiring circulatory arrest.
Findings:
- A transpulmonary balloon catheter serves as an effective occluder during suture placement.
- Nélaton's catheters are ingeniously employed as tourniquets to secure suture ties.
- This modified technique facilitates PDA closure while maintaining systemic circulation.
Implications:
- Offers a potentially safer alternative for adult PDA patients with severe comorbidities.
- May reduce the risks associated with circulatory arrest in complex cardiac surgeries.
- Highlights innovative use of readily available medical devices in surgical procedures.
Abstract:
Patent ductus arteriosus (PDA) in adults is occasionally associated with calcification and pulmonary hypertension, for which an anterior approach through a median sternotomy with cardiopulmonary bypass is often used. Sutures are placed without circulatory arrest by using a transpulmonary balloon catheter as an occluder. To secure the suture tie, we used Nélaton's catheters as tourniquets.