Surgical management of patent ductus arteriosus in newborn infants of low birthweights

The increased survival of small neonates with hyaline membrane disease has led to an increase in patent ductus arteriosus in such neonates. Durirng the period of this study patent ductus arteriosus occurred in 21 % of all newborn infants who weighed <2500 g, and were seen at this hospital; the proportion increased with decreasing birthweight and gestational age.1 Patent ductus arteriosus often coexists with hyaline membrane disease.2 Congestive heart failure may result from a large left-to-right shunt through the ductus arteriosus. Ventilatory support is prolonged and spontaneous closure delayed. Although congestive heart failure may be controlled by ventilatory and medical measures, many of the neonates remain ventilatordependent and require further intervention by pharmacological or surgical means. A lack of clear evidence incriminating the ductus arteriosus as the cause of the complications associated with hyaline membrane disease (such as bronchopulmonary dysplasia or necrotising enterocolitis), results in uncertainty about the preferred method and timing of ductal closure. We report our surgical experience with patent ductus arteriosus.