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Ann Thorac Surg 1976;22:151-156
© 1976 The Society of Thoracic Surgeons

Articles

The Ductus Debate: Ligation in Prematurity?

Willis H. Williams, M.D., Henry Gelband, M.D., Eduardo Bancalari, M.D., Charles Bauer, M.D., Otto Garcia, M.D., Dolores Tamer, M.D., Gerard A. Kaiser, M.D.*

From the Division of Thoracic and Cardiovascular Surgery, the Department of Pediatrics, and the Division of Pediatric Cardiology, University of Miami School of Medicine and Jackson Memorial Hospital, Miami, FL.

Accepted for publication February 16, 1976.

* Address reprint requests to Dr. Kaiser, Division of Thoracic and Cardiovascular Surgery, PO Box 520875, Miami, FL 33152.

This report describes 20 premature infants who have undergone surgical ligation of a patent ductus arteriosus (PDA), diagnosed solely by physical examination in all but 2 instances. There were no operative deaths. Eleven of these 20 infants had severe associated hyaline membrane disease (HMD) necessitating mechanical ventilatory support from the first or second day of life. Only 3 of these 11 infants (27%) ultimately survived to leave the hospital. In contrast, 8 of 9 premature neonates (89%) with severe congestive heart failure but without HMD were discharged alive.

Surgical ligation of the PDA in a premature infant is an appropriate and successful mode of treatment when congestive heart failure is refractory to medical management. Proof is lacking, however, to establish the efficacy of PDA ligation in the premature infant with HMD.




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