Related Experiment Videos
Operation for adult patent ductus arteriosus using cardiopulmonary bypass
R Toda1, Y Moriyama, M Yamashita
1Second Department of Surgery, Faculty of Medicine, Kagoshima University, and National Minami Kyushu Chuoh Hospital, Japan. toda@med6.kufm.kagoshima-u.ac.jp
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.