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 The lung was
retracted with a small rolled gauze gently.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.