Surgical correction of patent ductus arteriosus in adults: is there a concern ?

  • Dr Rachel Haickel Nina, University Hospital of the Federal University of Maranhão, São Luis-MA, Brazil, Brazil
  • Dr Vinicius Nina, University Hospital of the Federal University of Maranhão, São Luis-MA, Brazil, Brazil
  • Dr José Figueiredo Neto, University Hospital of the Federal University of Maranhão, São Luis-MA, Brazil
  • Ms Ana Carolina de Castro, University Hospital of the Federal University of Maranhão, São Luis-MA, Brazil, Brazil
  • Ms Camila Nogueira, University Hospital of the Federal University of Maranhão, São Luis-MA, Brazil, Brazil
  • Ms Caroline Ramos, University Hospital of the Federal University of Maranhão, São Luis-MA, Brazil, Brazil
  • Ms Leiliana Coelho, University Hospital of the Federal University of Maranhão, São Luis-MA, Brazil, Brazil
  • Ms Silmara Rodrigues, University Hospital of the Federal University of Maranhão, São Luis-MA, Brazil, Brazil

    • Objective: the aim of this study was to analyze the outcomes of the surgical correction of Patent Ductus Arteriosus (PDA) in the adult population.
    Methods: From January 2003 through June 2008, 22 patients (17 female) with mean age of 23.09 years underwent surgical correction of PDA. All patients had a preoperative angiogram to measure the pulmonary artery pressure(PAP). The surgical approach consisted on a left thoracotomy in the fourth intercostal space followed either by division and suture of the ductus in 15 or by a purse-string suture only in 7(calcified ductus).
    Results: major preoperative symptoms were exertional dyspnea(22),chest pain(6) and palpitations(5). Mean systolic PAP was 44.8 mmHg (20-110 mmHg). The average of mechanical ventilation time was 3.1hours. There was no mortality and the mean length of hospital stay was 5.8 days. The complication rate was 50% - 11 cases of which: hypertension(4), bleeding(3), arrhythmia(2), pericarditis(1) and chest pain(1). There were no specific complications related to either techniques used to close the PDA.
    Conclusion: surgical correction of PDA in adults is sometimes technically demanding due to the occurrence of calcification, friable tissues and pulmonary hypertension. However, it can be safely performed with low mortality and acceptable morbidity.