SURGICAL DIVISION OF THE PATENT DUCTUS ARTERIOSUS

SURGICAL closure is now the uniformly accepted method of treatment of the patent ductus arteriosus. Whether a ductus is ligated or divided is largely a matter of individual preference. In our early work my colleagues and I ligated 21 consecutive ducti. Although examinations during the immediate postoperative period revealed no evidence of incomplete closure and later follow-up examinations brought to light no suspicion of recanalization, we prefer division and suture and for the following reasons: It is very difficult to know exactly how much tension to put on ligatures when tying a ductus—too little, and the ductus is incompletely occluded—too much, and the ligature cuts through. It is not desirable to bury large amounts of nonabsorbable heavy suture material about the bronchus and large vessels. Late recanalization cannot occur if the ductus has been cut and sutured. With proper technique there is less danger of operative hemorrhage when dividing