A safe technique for closure of the recurrent patent ductus arteriosus.

In an early series of 73 operations for patent ductus arteriosus, closure was by the triple ligation method. Over a short period, recurrence of patency was observed in 2 cases and after that the technique of division and suture rather than ligation became standard. For closure of the recurrent ductus, a modification of the usual technique is necessary to minimize danger of injury to the recurrent nerve and the great vessels. A safe method was devised which involves an intrapericardial approach to the superior aspect of the ductus and dissection inferiorly which avoids denudation of the aorta. This technique was used with satisfaction in 6 cases of recurrent patent ductus arteriosus.