Ann Short Rep | Volume 1, Issue 6 | Research Article | Open Access
Lakshmi Kumari Sankhyan1, Ujjwal Kumar Chowdhury1*, Vasubabu Gudala1, Suruchi Hasija2, Vishwas Malik2 and Priya Jagia3
1Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, India
2Department of Cardiac Anaesthesia, All India Institute of Medical Sciences, India
3Department of Cardiac Radiology, All India Institute of Medical Sciences, India
*Correspondance to: Ujjwal Kumar Chowdhury
Fulltext PDFBackground: Use of trans pulmonary approach under normothermic cardiopulmonary bypass without circulatory arrest has been poorly documented for the giant ductus, adult ductus, recanalized and calcified ductus as an alternative to decrease the high perioperative complication rate associated with division and suture. Patients and
Methods: Between January 1998 and September 2018, 18 consecutive patients underwent closure of persistent ductus arteriosus under normothermic cardiopulmonary bypass without circulatory arrest via trans-pulmonary approach for adult ductus. Age ranged from 26 to 35 years. Indications were adult ductus arteriosus (n=3), calcified ductus (n=6), infected ductus (n=1), window ductus (n=2), short and wide ductus (n=2), giant ductus (n=3) and recanalized ductus (n=1).
Results: There was no early or late death. There was no phrenic or left recurrent laryngeal nerve damage, chylothorax, massive bleeding or recanalization. At a mean follow-up of 12.6 ± 5.8 years, all patients are in NYHA functional class I. Computerized tomographic angiography (n=14) revealed complete ductal interruption with no residual shunt or ductal aneurysms.
Conclusion: On the basis of these results, ductal closure via trans-pulmonary balloon occlusion under normothermic cardiopulmonary bypass without circulatory arrest appears to be a versatile technique for ductal closure presenting in adulthood and eliminates the operative complications associated with ductal division and suture. We believe that the absence of mortality and morbidity resulted from careful operative technique and complete closure guided by intraoperative transesophageal echocardiography. Long-term evaluation will be mandatory to assess the possible occurrence of specific complications encountered with cardiopulmonary bypass.
Adult ductus arteriosus; Calcified adult ductus; Recanalized ductus arteriosus; Hypertensive ductus arteriosus; Window ductus arteriosus; Giant ductus arteriosus; Ductal closure under cardiopulmonary bypass
Sankhyan LK, Chowdhury UK, Gudala V, Hasija S, Malik V, Jagia P. Surgical Management of the Adult Ductus, the Giant Ductus, the Recanalized and Calcified Ductus using Normothermic Cardiopulmonary Bypass without Circulatory Arrest: Review of 20 Years’ Experience. Ann Short Reports. 2018;1:1028.