Results of Closure of Patent Ductus Arteriosus in Adult Population Using Cardiopulmonary Bypass

Background: Surgical repair of patent ductus arteriosus (PDA) in adults is more challenging compared to children. This study was conducted to report our experience using cardiopulmonary bypass (CPB) in adult cases with PDA.
Aim of the work: The objective of this study is to evaluate the safety and efficacy of the usage of the cardiopulmonary bypass in management of PDA in the adult population, not suitable for trans-catheter closure.
Patients and methods: This is a retrospective study that included all adult cases with PDA who had surgical closure for 5 years (July 2014 to July 2019) at the Cardiothoracic Surgery Department at Mansoura University, Egypt. All demographic, clinical, and Echo-derived data were collected, New York Heart Association (NYHA) class was calculated for all cases before operation. All cases underwent PDA repair using CBP. Postoperatively, clinical and radiological assessments were performed 6 months after surgery.
Results: The study included a total of 10 cases (7 males and 3 females). Their mean age was 32.2 years. Eight cases of them had NYHA class II, and the remaining cases had NYHA class III. Direct closure was performed in 6 cases (60%), and the other 4 cases had patch closure. The mean CBP and aortic clamping times were 97 and 45.5 minutes respectively. The mean esophageal temperature was 30.50 ºC. Neither mortality nor reoperation was encountered in the current study. Six months after the operation, pulmonary artery pressure decreased from 43.6 mmHg down to 25 mmHg and NYHA class I was present in 8 cases while the other 2 cases had NYHA class II. Conclusions: A cardiopulmonary bypass is a safe option for adult cases with patent ductus arteriosus unsuitable for percutaneous or minimally invasive closure.