The authors describe the surgery for patent ductus arteriosus (PDA) with triple ligature through the extrapleural path. After general anesthesia, the child has his position in the right lateral and a little ventral decubitus. A small incision is made in the inferior limit of the scapula. The pleura is dissected and the PDA exposed, double ligated with Polyester 2/0 and transfixed and tightened with Polypropilene 4/0. With this technique it is not necessary to have a chest tube. Fourty seven patients with PDA were submitted to surgery between September 1988 and August 1990; in 40 patients it was possible to do this type of surgery. Ages ranged from 4 months to 11 years, with mean age of 3.1 ± 3.0 years. Twenty children were less than one year old. There were 24 females and 16 males. No cases of intra or post-operative complications were registered. The follow-up ranged from 7 to 30 months (mean 15.3 months). Ali children were submitted to clinical evaluation, thoracic Rx and ecocopplercardiography. No patients presented recanalization or other complications. This experience showed that this tecnique is reliable, efective and it does not present immediate and late morbility or mortality. This technique can be safely used in younger as well as older children.
patent ductus arteriosus