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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: Reply

^a Second Department of Surgery, Faculty of Medicine, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima 890-8520, Japan
^b Division of Cardiovascular Surgery, National Takasaki Hospital, Takasaki, Japan

e-mail: toda{at}med6.kufm.kagoshima-u.ac.jp

To the Editor

We thank Tokuda and associates for their interest in our article regarding adult patent ductus arteriosus (PDA) operation [1]. We agree with the feasibility of transcatheter coil closure for PDA patients [2]. However, the indication should be restricted for adult patients. Four of 9 patients in our series had calcification around the ductus, and some patients without calcification had high pulmonary arterial pressures. These conditions could be hazardous for transcatheter coil closure. We suggest that transcatheter coil closure is not appropriate for these patients.

It is not known how many adult PDA patients have calcification around the ductus. Moreover, the friability of the ductus should be considered. Complications such as thromboembolism, hemolysis, stenosis or leakage are concerns in adult patients who may have atheroscrelotic changes in the artery or ductus due to aging, or both. Cardiopulmonary bypass (CPB) is performed very safely. Although it is controversial which is more safe—cardiopulmonary bypass or transcatheter closure—we recommend CPB because of the ductal and arterial age related changes. We feel that further investigation of the indications for transcatheter coil closure for adult PDA patients is required.

Addendum

In our article [1], we missed a report by Arai [3] in 1970. His report was published before Bhati and colleagues’ article [4] regarding patch closure of the ductus.

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. Arai T. Surgical treatment of ductus arteriosus with the enlarged pulmonary artery in the aged. Kyobu-Geka Japanese Journal of Thoracic Surgery 1970;23:722-727.
4. Bhati B.S., Nandakumaran C.P., Shatapathy P., John S., Cherian G. Closure of patent ductus arteriosus during open heart surgery. J Thorac Cardiovasc Surg 1972;63:820-826.[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 Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Yukinori Moriyama Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Toda, R. Articles by Moriyama, Y. Search for Related Content PubMed Articles by Toda, R. Articles by Moriyama, Y. Related Collections Congenital - acyanotic Related Article