Surgical Technique
In the operating room, three-lead electrocardiography and pulse oximetry were used for routine monitoring. The patient was under a heater until the operation started. Central venous catheter or invasive arterial monitoring were not used routinely. Adrenalin infusion was started routinely. In left anterior mini-thoracotomy technique, approximately 2-3 cm incision was made through the second intercostal space. The incision was limited to left internal mammarian artery. The lung was retracted with a small rolled gauze gently. A longitudinal incision 1cm above the phrenic nerve was made. Then a stay suture was placed at pericardium to visualize the ductus and the pulmonary arteries. After the dissection of the lateral surfaces of the ductus was completed a clip was placed on the PDA or the PDA was ligated with a 2‐0 silk suture.Especially in the case of fragile and thin‐walled PDAs, single clip was prefered. The surgical incision was closed with interrupted 4/0 prolene sutures without a chest tube (Figure 1). The study was conducted in accordance with the principles of the Declaration of Helsinki and was approved by the ethics committee. Permission for this study was granted by the Dr. Gazi Yasargil Training and Research Hospital Ethical Committee of Clinical Researches with the decision number 26 and date 11.02.2022.