John S, Muralidharan S, Jairaj P S, Mani G K, Krishnaswamy S, Sukumar I P, Cherian G
J Thorac Cardiovasc Surg. 1981 Aug;82(2):314-9.
Results in patients over 14 years of age who have undergone surgical closure of a patent ductus arteriosus during the period 1967 through 1979 have been reviewed. There were 131 subjects (average age 22 years) with a slight male predominance, which is at variance with other reports. Sixty-two subjects underwent hemodynamic evaluation and of these, 30 had pulmonary artery pressures ranging from 50 to 150 mm Hg. Division and suture of the ductus with aortic cross-clamping under normothermic conditions was performed in 61 subjects. This approach was particularly indicated in cases in which the ductus was unusually short in relation to its diameter as well as in many with atheromatous changes at the aortic end. In 65 subjects, the conventional division and suture with ductus clamps was employed. Total cardiopulmonary bypass with transaortic patch closure of the ductus was carried out in three instances. There were five early deaths which were principally associated with severe pulmonary hypertension. During a follow-up period extending from 1 to 11 years, three subjects died, but the remainder are well and active. Recatheterization data in nine patients with severe pulmonary hypertension showed gratifying results.
对1967年至1979年期间接受动脉导管未闭手术闭合的14岁以上患者的结果进行了回顾。共有131名受试者（平均年龄22岁），男性略占优势，这与其他报告不同。62名受试者接受了血流动力学评估，其中30名肺动脉压力范围为50至150 mmHg。61名受试者在常温条件下进行了主动脉交叉钳夹下的动脉导管切断缝合。这种方法特别适用于动脉导管相对于其直径异常短以及许多主动脉端有动脉粥样硬化改变的病例。65名受试者采用了传统的动脉导管钳夹切断缝合方法。3例采用了经主动脉补片闭合动脉导管的全心肺转流术。有5例早期死亡，主要与严重肺动脉高压有关。在1至11年的随访期内，3名受试者死亡，但其余受试者情况良好且活动正常。9例严重肺动脉高压患者的再次导管检查数据显示出令人满意的结果。
