Hara Y, Kamihira S, Ishiguro S, Kuroda H, Sasaki S, Mori T
Second Department of Surgery, Faculty of Medicine, Tottori University, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1993 Apr;41(4):610-3.
Ten patients over the age of 30 were operated on for isolated patent ductus arteriosus (PDA). Division was performed in 9 patients and ligation in only one. In two cases, the aorta had to be cross-clamped above and below the level of the ductus under normothermia because of massive bleeding. In another two patients with aneurysmal dilatation and calcification of the aortic side of the ductus, PDA was closed by aortic cross-clamping under LA-to-femoral-artery bypass with a centrifugal pump. Postoperatively, all patients are well and in NYHA class I. Therefore, in the adult, if the conventional method of division between ductus clamps is considered dangerous due to increased friability and atheromatous changes of the ductus and surrounding tissues, the ductus should be closed during aortic cross-clamping under assist circulation. In such a case, LA bypass is considered quite useful and safe.