Background: Repair of complicated patent ductus arteriosus by conventional methods is dangerous as life-threatening hemorrhages may occur. Thus, in these patients, it is safer to operate by using cardiopulmonary bypass and hypothermic circulatory arrest.

Methods: We operated on 5 patients with patent ductus arteriosus with deep hypothermia and total circulatory arrest between 1993 and 2003. All of the patients were female and their ages were between 9 and 51. The mean shunt ratio was 2.7 ± 0.45 and mean systolic pulmonary arterial pressure was 59 ± 17.46 mmHg. In three of the patients the ductus was wide and thick, it was aneurysmatic in one and calcified in the other. All of the patients were operated under cardiopulmonary bypass and were cooled down to an average temperature of 21.6 ± 2.07 °C. The mean total circulatory arrest time was 14.4 ± 9.66 minutes (range 3-25). In two patients, the ductus was closed with a transpulmonary approach while in one patient a transaortic approach was used. All sutures were consolidated with pledgets. In one patient the transfixation was performed without pulmonary arteriotomy using three pledgetted sutures placed externally. In the last one patient, the repair was achieved by division. In addition to patent ductus arteriosus correction, concomitant procedures were subaortic discrete membrane resection, aortic valve replacement in two patients. In one patient, right ventricular outflow tract was enlarged with a transannular patch and foramen ovale was closed.

Results: There was no early or late mortality. In two patients inotropic support was needed during weaning from cardiopulmonary bypass. No complications were seen related to the procedure itself. The mean follow up was 31.8 ± 39.97 months. No recanalisation was detected with the postoperative echocardiographic assessment.

Conclusions: Hypothermic total circulatory arrest can be used safely during the repair of complicated patent ductus arteriosus without exposing the patient to additional risks.

Keywords : Patent ductus arteriosus, deep hypothermia, circulatory arrest