Background and Aim of study Frequently in low-birth-weight infants, ductus arteriosus fails to close spontaneously. This study evaluates the results of surgical ligation of symptomatic PDA in low birth weights preterms.

Methods We reviewed the medical records of all infants undergoing surgical closure of PDA from 2000 to 2010. Demographic data, weight at operation, respiratory assistance pre-operatory, surgical technique to close PDA and outcome were analyzed.

Results Thirty infants underwent surgical closure of PDA in which either indomethacin or ibuprofen treatment had failed or was contraindicated. The mean GA was 27 and the mean birth weight was 752 g. The average weight at operation was 790.5 g. PDA was surgically closed by left thoracotomy using hemoclips.

Postoperative complication occurred in 4 patients, which included intraoperative bleeding (1), pneumothorax (1), lymphatic leak (2). No vocal cord paralysis nor diaphragmatic paralysis were observed. We also registered outcomes related to PDA: broncodisplasia (22), IVH(8), NEC(8), ROP(13). There was no mortality related to surgery.

Conclusion We conclude that surgical closure of hemodynamically significant PDA is safe and effective in preterm low birth weights infants when pharmacological treatment is ineffective or contraindicated. The associated morbidity is minimal and no surgery-related mortality was observed.