Intra-aortic closure of the calcified patent ductus: a new operative method not requiring cardiopulmonary bypass.

Diffuse and circumferential calcification of the patent ductus arteriosus is a rare finding frequently associated with severe pulmonary artery hypertension. Under this circumstance, closure of the patent ductus arteriosus by ligation in continuity or by division and suture is hazardous if not impossible. Endoaortic closure of the ductus with a prosthetic patch has been proposed as an alternate and safer procedure. This paper describes an improved operative technique for intra-aortic closure of a calcified patent ductus arteriosus employing a heparin-coated shunt to permit aortic cross-clamping and an intraluminal balloon catheter to control bleeding from the pulmonary artery. Extracorporeal circulation and systemic heparinization are avoided. Minimal manipulation of the ductus and pulmonary artery is required.