engleski

Transpulmonary closure of patent ductus arteriosus in older adults

The majority of patent ductus arteriosus (PDA) patients underwent a surgical correction in childhood. Some patients reach the adult age with that malformation. Aim of this study is to analyze early and late results after transpulmonary closure of patent ductus arteriosus in adults. In period of 8 years, 9 patients (mean age 51, 4 years, 7 male) were operated for PDA. All patients were operated transpulmonary using cardiopulmonary bypass with hypothermia 22˚ C. In group A (5 pts), PDA was closed in circulatory arrest, and group B (4 pts), using low flow (0, 5 L min/m2) cardiopulmonary bypass. Two patients had coexisting failure, one ASD and second aortic regurgitation. Indications for operation were evidence of PDA with L-R shunt over 30% (mean 40%) and dyspnea. In all patients diagnosis of PDA was established by transesophageal two-dimensional Doppler echocardiography and cardiac catheterization. Mean perfusion time in group A was 165 min vs. group B 166 min. Circulatory arrest in group A was 14 min, and low flow perfusion in group B was 10 min. There were no deaths in both groups. All patients were postoperatively followed regarding dyspnea and residual shunt using echocardiography (mean follow-up was 29 months, range 2 to 59 months). Actual survival and dyspnea freedom at 3 years was 100 %. 1. Transpulmonary closure of the patent ductus arteriosus in adults using cardiopulmonary bypass is save method. 2. There is no difference in mortality, morbidity, early and late results in both groups. 3. Coexisting failure (ASD, AI) do not influence the operative outcome.

patent ductus arteriosus; adults

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