Surgical treatment of the aged patient with patent ductus arteriosus.

A 62-year-old woman with massively calcified patent ductus arteriosus (PDA) associated with severe pulmonary hypertension and bilateral hydronephrosis was successfully operated upon. At first, percutaneous nephrostomy was performed under ultrasonographic guidance. Two weeks later, PDA was repaired under cardiopulmonary (CP) bypass, since its division through a left thoracotomy was considered to be fraught with danger. A Foley's balloon catheter was inserted into the aorta through the ductus after a pulmonary arteriotomy under CP bypass. The ductus was closed simpler and safer with a patch mounted on the catheter, because blood flow from the aorta was well controlled by the inflated balloon catheter.