The Annals of Thoracic Surgery, Vol 32, 166-172, Copyright © 1981 by The Society of Thoracic Surgeons
Ligation of patent ductus arteriosus in premature infants
B Brandt, WJ Marvin, JL Ehrenhaft, S Heintz and DB Doty
In the operating room, 66 preterm infants weighing between 710 and 2,700 gm
(23 less than 1,000 gm) underwent ligation of a patent ductus arteriosus
(PDA). Respiratory distress syndrome was present in 53 patients; the rest
had apnea-bradycardia syndrome. PDA ligation was indicated for intractable
congestive heart failure in 52 patients or progressive respiratory failure
in 14. There were no intraoperative deaths. Fifteen infants died 1 to 120
days postoperatively. Seven deaths resulted from intracranial bleeding, 3
from diffuse coagulopathy, and 1 from respiratory failure. The condition of
patients with heart failure improved postoperatively, with the mean left
atrium to aorta ratio reduced from 1.56 to 1.02 (p = 0.05). Respiratory
function improved in 25 patients extubated by the third postoperative day.
Late follow-up (one to five years) of the 51 survivors showed 1 late death.
Seventeen survivors had roentgenographic evidence of bronchopulmonary
dysplasia. Infants with bronchopulmonary dysplasia required longer
postoperative ventilation (mean, 21.5 days compared with 4.75 days).
Twenty-four infants were normal. Ligation of PDA in preterm infants has low
intraoperative risk and improves the condition of those with heart and
respiratory failure. Late follow-up showed good recovery of nearly
two-thirds of the patients.
