[Surgical treatment of difficult patent ductus arteriosus and related operative complications]

Sixty-nine patients with difficult patent ductus arteriosus (PDA) were retrospectively studied. The PDA included window type (9 patients), aneurysms of the ductus arteriosus(13), large ductus(15), false aneurysms(3), calcified(3), recurrence of ductal patency(5), endarteritis(5) and severe pulmonary hypertension(16). Surgical procedures included ligation of PDA in 51 patients, ligation with Dacron pledget or ribbon in 9, division of PDA under temporary cardiopulmonary bypass in 5. Ruptures of PDA or aorta in 4 patients were repaired respectively with Dacron patch(2) and conduit (2). There were 2 early deaths (2.9%). The mean follow-up was 119 months clinically. All surviors were free from symptoms andcardiac murmur. We conclude that satisfied surgical results rely mainly on proper operative techniques according to different situations of difficult PDA. Surgical correction with Dacron patch or conduit seems to be a simple, safte and reliable method in dealing with the rupture of PDA or aorta.