Ng A S, Vlietstra R E, Danielson G K, Smith H C, Puga F J
Int J Cardiol. 1986 Jun;11(3):277-85. doi: 10.1016/0167-5273(86)90032-x.
At the Mayo Clinic, from 1945 through 1983, a definitive diagnosis of patent ductus arteriosus was first made in 38 patients when they were more than 50 years old. Of the 29 patients who had cardiac catheterization, 14 had a small left-to-right shunt, 7 had a moderate shunt, and 8 had a large shunt. Five patients, including 2 with right-to-left shunts through the ductus, had pulmonary systolic pressures greater than 75 mm Hg. Thirty procedures were done in 29 patients: ductal ligation in 7, division and suture in 13, transaortic patch closure in 3, and closure via median sternotomy with extracorporeal circulation in 7. There was one intraoperative death (operative mortality, 3.3%). Although technically more challenging, surgical repair is associated with low mortality and excellent follow-up survival. The patients who benefit most from surgical correction are those with Qp/Qs greater than 1.5 and pulmonary artery systolic pressure less than 75 mm Hg.
在梅奥诊所，从1945年到1983年，38例患者在50岁以上时首次被明确诊断为动脉导管未闭。在接受心导管检查的29例患者中，14例有小的左向右分流，7例有中度分流，8例有大量分流。5例患者，包括2例通过导管有右向左分流的患者，肺动脉收缩压大于75mmHg。29例患者共进行了30次手术：7例行导管结扎术，13例行切断缝合术，3例行经主动脉补片修补术，7例行体外循环下经正中胸骨切开术修补术。有1例术中死亡（手术死亡率为3.3%）。尽管手术在技术上更具挑战性，但手术修复的死亡率较低，随访生存率良好。手术矫正受益最大的患者是那些Qp/Qs大于1.5且肺动脉收缩压小于75mmHg的患者。
