The Annals of Thoracic Surgery, Vol 23, 564-567, Copyright © 1977 by The Society of Thoracic Surgeons
Ligation of the patent ductus arteriousus in the newborn intensive care unit
SC Oxnard, C McGough, AL Jung and HD Ruttenberg
During a two-year period, 21 premature infants (weight at birth, 680 to
2,340 gm) had operative closure of patent ductus arteriosus (PDA). The
first 6 infants had ligation performed in the operating room (OR); the
subsequent 15 had ligation in the Newborn Intensive Care Unit. There were
no immediate postoperative deaths. Two infants died from problems presnet
preoperatively within 30 days postoperatively. There were no infections.
Technique in the unit utilizes an open warmer with local anesthesia and a
paralyzing agent. By eliminating transportation to the OR one avoids
problems with thermoregulation, loss of lines, malfunction of monitors,
poorly controlled ventilation, and fluid overload. Additional advantages to
ligation in the unit are that the infant is already monitored, intubated,
and on a respirator, and that venous and usually umbilical arterial lines
are in place. At the conclusion of operation, management is returned to the
neonatologists for optimal continuity of care.
