[Surgical treatment for patient ductus arteriosus in an aged patient]

A successful closure of patent ductus arteriosus (PDA) in a 70-year-old women is described. The patient had poor pulmonary function and calcification of the aortic arch and the descending aorta, as well as arteriosclerosis obliterans bilaterally in the iliac arteries. We therefore performed trans-pulmonary artery direct closure of the ductus arteriosus via a median strenotomy. In surgery, we used a Foley balloon catheter inserted into the aorta through the ductus to prevent backflow. Leakage of blood from the ductus, even with use of balloon occlusion, required the reduction of perfusion flow to 500 ml/min and temporary circulatory arrest. Rectal temperature was 27 degrees C when the aorta was cross-clamped. The ductus orifice was primarily closed with three mattress sutures with pledgets, and this sutured orifice was secondarily covered with a bovine pericardial patch. The postoperative course was satisfactory. Trans-pulmonary artery direct closure of the PDA using cardiopulmonary bypass is useful for aged patients. This patient is, as far as our knowledge, the oldest surgical report in Japan.