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Ann Thorac Surg 2001;72:2186
© 2001 The Society of Thoracic Surgeons

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Correspondence

Optimal treatment for adult patent ductus arteriosus

^a Department of Cardiovascular Surgery, Tenri Hospital, Mishima 200, Tenri City, Nara 632-8552, Japan

e-mail: tokuda{at}mxb.mesh.ne.jp

To the Editor

In the December 2000 issue of The Annals, Toda and colleagues [1] reported good results of the operations for 9 adult patent ductus arteriosus (PDA) patients using cardiopulmonary bypass and an occlusion balloon. However, based on our clinical experience, we consider that in patients where there is no calcification around the PDA, transcatheter coil closure is a better treatment for adult PDA patients because it is less invasive.

Recently, the transcatheter coil closure of a small PDA has become widely used for children, but it is still not frequently performed in older patients. We successfully performed antegrade transcatheter coil closure of a large PDA in a 70-year-old woman; the PDA was 4.6 mm in minimal diameter and the calculated pulmonary-to-systemic flow ratio was 1.56 to 1. Using the cardiac muscle biopsy foreceps through the end hole catheter, two large 0.052-inch Gianturco coils (Cook Inc, Bloomington, IN) were implanted in the PDA. Complete occlusion was obtained without any complication. Our method is the modification of the new coil delivery method that Grifka and Jones [2] reported in a child with large PDA. Oishi and colleagues [3] have also reported coil closure of the PDA in an adult patient with smaller 0.038-inch coil.

The long-term result of our case of the coil closure of PDA is unknown. It is also important to monitor the development of late complications such as hemolysis, delayed pulmonary arterial stenosis, or recurrent leakage. However, we consider that transcatheter coil closure is a feasible procedure for an adult PDA patient, especially in elderly patients. Further investigation may extend its indication.

References

1. Toda R., Moriyama Y., Yamashita M., Iguro Y., Matsumoto H., Yotsumoto G. Operation for adult patent ductus arteriosus using cardiopulmonary bypass. Ann Thorac Surg 2000;70:1935-1938.[Abstract/Free Full Text]
2. Grifka R.G., Jones T.K. Transcatheter closure of large PDA using 0.052‘ Gianturco coils. Catheter Cardiovasc Interv 2000;49:301-306.[Medline]
3. Oishi Y., Okamoto M., Sueda T., Hashimoto M., Karakawa S., Akira T. Transcatheter coil embolization of large-size patent ductus arteriosus in adult patients. Jpn Circ J 1999;63:994-998.[Medline]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Masahiko Matsumoto Takaaki Sugita Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Tokuda, Y. Articles by Sugita, T. Search for Related Content PubMed PubMed Citation Articles by Tokuda, Y. Articles by Sugita, T. Related Collections Congenital - acyanotic Related Articles