Surgical ligation of the patent ductus arteriosus in low birth weight pre-term infants. A review of 67 consecutive cases.

Between March 1978 and October 1983, sixty-seven low birth weight infants (600-1500 gm) with gestational age of 26-33 weeks had surgical ligation of PDA in our unit. Thirty-six (54%) had previous failed indomethacin therapy. Congestive cardiac failure (61), respiratory distress syndrome (48) and failure to thrive (34) were the presenting features. Nine patients had severe acidosis (pH 6.8-7.18) on admission. A trans-pleural approach was used in all. Ventilation was required for 1-13 days. There were no intra-operative deaths. Sixteen (24%) died of the problems of prematurity. The others have continued to thrive. We believe that ligation of PDA is a safe and effective procedure in the low birth weight premature infant, but should only be undertaken in a well set up paediatric cardiac surgical unit.