Intrapericardial Ligation of Patent Ductus Arteriosus through Median Sternotomy / 第三军医大学学报

ABSTRACT

Twelve cases of patent ductus arteriosus (PDA) were treated with intraperi-cardial ligation through a median sternotomy during a 4-year period from 1980 to 1983. Among the 12 cases, 5 were associated with ventricular septum defect, 1 was complicated with right descending thoracic aorta and the ductus was situated at the right side of mediastinum, 1 case had the anomaly of type Ⅲ aor-tico-pulmonary window and PDA coexisted with that anomaly.A new surgical approach to the intrapericardial ligation of patent ductus arteriosus through a median sternotomy was suggested as follows:(1) Thorough dissection is done to isolate the ascending aorta completely from the main pulmonary artery.(2) A thread is passed around the upper part of the ascending aorta and pull it rightward.(3) A right angled retractor is placed under the upper edge of the fsternal incision and pull it leftward.(4) An assistant retracts the pulmonary artery downward to put the artery on tesion.It was suggested that exploration of the PDA area be a routine procedure before extracorporeal circulation is exployed.Furthermore.intrapericardial ligation of patent ductus arteriosus is one of the basic procedures a cardiac surgeon must be skillful at.