J.Jpn. Surg. Soc.. 81(9): 1181-1182, 1980

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Report on the annual meeting

DISSECTION OF PATENT DUCTUS ARTERIOSUS UNDER SIMPLE HYPOTHERMIA

Dissection of a patent ductus arteriosus (PDA) is easily done under general anesthesia in usual cases. However in some cases, complicating pulmonary hypertention and ductal arteriosclerosis, application of simple hypothermia is recommended to prevent the unexpected bleeding during preparation and dissection of the PDA.
The merit of hypothermia is that it brings hypotention and bradycardia, resulting to avoid injury of ductus arteriosus during surgical manipulation.
Moreover, hypothermia is a safe method to occlude descending aorta temporarily for more than 30 minutes to repair teared aortic wall accidentally occurring during disection.
Firm ductal clamp is important especially at aortic side. For this reason, aortic partial occluding clamp is recommended instead of usual Pott's ductal clamp.
Body temperature was kept at 30ｰ28℃ during ductal dissection. Arterial systolic pressure decreased from 120ｰ130mmHg before cooling to 80ｰ90mmHg during hypothermia and heart rate decreased from 80/min. to 60/min. During 14 years, 129 cases of PDA were operated on, 93 cases were under hypothermia and 36 cases were under general anesthesia. Temporary aortic occlusion, for 6 to 40 minutes, was obliged in 10 cases to repair bleeding from aortic side. Postoperatively no complication was recongized after long term aortic occlusion.
Recently, most cases are small infant. The application of hypothermia is decreasing.

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