Early surgical intervention in premature infants with respiratory distress and patent ductus arteriosus

Ten premature infants with severe idiopathic respiratory distress syndrome and a large patent ductus arteriosus who underwent ligation are discussed. There were no surgical deaths, but two late deaths occurred. Three similar infants who were not operated on are also presented; all of them died. An additional forty-four such patients with ductus ligation reported on recently were reviewed. Evidence is presented that strongly supports ligation of the ductus as soon as it becomes apparent in infants with severe respirator-dependent idiopathic respiratory distress syndrome. The diagnosis of patent ductus arteriosus is reliably established clinically, and the relatively high complication rate associated with cardiac catheterization in premature infants contraindicates its use.