Patent ductus arteriosus in infants and children. A review of 936 operations (1946-69).

Nine hundred and thirty-six consecutive cases of closure of a patent ductus arteriosus in infants and children are reported. Among 789 without any other cardiac anomalies there were 11 deaths, seven of these with severe congenital anomalies other than cardiovascular. There was one incomplete closure. The deaths in this series were mostly associated with additional congenital cardiac anomalies. Forty-eight of the 59 who died had additional cardiac anomalies. Forty-seven of the deaths were in infants. For 691 patients over the age of 1 year the hospital mortality rate was less than 0·5%. Ligation of the ductus using two ligatures of thick plaited silk (1·2 mm diameter) was the technique used in 99% of these cases. There were four cases of recanalization or inadequate ligation but all four survived. This technique seems an acceptable one for the closure of a patent ductus arteriosus.