The adult ductus. Surgical results and long-term follow-up

Surgical treatment for the adult patent ductus can be a safe procedure if adequate aortic control is obtained. Long-term results are satisfactory, except for patients with pulmonary hypertension, of whom only 50 per cent obtain a good result. We believe operative treatment is indicated in the asymptomatic adult patient with patent ductus arteriosus, because one cannot predict which patients will develop pulmonary hypertension. In our group pulmonary hypertension developed in patients whose average age was the same as those who were asymptomatic. Those patients who are New York Heart Association (NYHA) class III usually have pulmonary hypertension, large ductus, and calcification, all of which could cause operative complications. Therefore, it is relatively easy to predict by symptoms alone which patients have the highest operative risk.