The Treatment of Patent Ductus Arteriosus

¹ The Division of Thoracic Surgery, University of Oregon Medical School Hospitals and Clinics and the Matson Memorial Hospital for Diseases of the Chest.

The literature concerning patent ductus arteriosus is briefly reviewed.

A persistent patent ductus arteriosus may be eliminated by surgical division or ligation. When the duct remains open after the first year of life, spontaneous obliteration is not likely to occur. Unless associated with other cardiovascular anomalies, its surgical treatment in children over the age of four years should be considered in order that life expectancy may be increased. The surgical mortality in skilled hands is sufficiently low to justify this conclusion.

Since recanalization has frequently followed ligation of a patent ductus arteriosus, division is considered the procedure of choice. A modified technic for division of a patent ductus arteriosus is presented. This technic is considered to have several advantages, being safer and more widely applicable than the technics now in use.

Twelve cases are reported in which the diagnosis of patent ductus arteriosus was made and operation performed. In one case the preoperative diagnosis of patent ductus was in error. There was one surgical (anesthetic?) death.

Other cases reported in detail include: one in which massive hemorrhage occurred following division of the duct and in which convalescence was complicated by the occurrence of pulmonary emboli; one in which the aorta was clamped for a total of thirty- five minutes while hemorrhage was being controlled and the duct divided; one case in which attacks resembling narcolepsy were apparently relieved following ligation of the duct; and one in which decortication of the lung was performed at the time of ductus ligation.