Patent ductus arteriosus (PDA) is an important cause of morbi-mortality in preterm newborns.

Our study aimed to analyze efficacy and safety of surgical closure of PDA using anterior mini-thoracotomy in very low weight preterm babies.

Monocentric and retrospective study including 21 preterms<1.3 kgs, who underwent surgical closure of PDA through anterior mini-thoracotomy, between 2010 and 2016.

Mean gestational age (GA) at birth was 25.9±1.2 weeks, mean weight at birth was 734±133 gr. Mean age at the time of surgery was 25.4±9.6 days. Mean corrected age and weight at surgery were 29.6±1.6 weeks of GA and 1058±166 gr respectively. In total, 90.5% of neonates had at least one trial of ibuprofen before surgery. Eighteen patients (85.7%) were ventilated before surgery. Median follow-up was 68.5 days [11 to 273 days] after surgery. No death related to surgery occurred. Three patients died 49, 65 and 204 days after surgery, due to sepsis, not considered related to surgery. Immediate post-operative echocardiography showed non significant residual shunt in only 1 patient (4.8%), and complete closure in the 20 remaining babies. Median time to extubation was 6 [3–16] days. One patient (4.8%) had a local complication (wound infection) and 5 patients (23.8%) presented transient instability, either hemodynamic (n=2 patients (9.5%)), respiratory (n=1 (4.8%)) or combined (n=2 (9.5%)).

Surgical PDA closure using anterior mini-thoracotomy is an effective and safe technique under experienced hands, for PDA closure in very low weight preterm babies. This technique needs to be compared with transcatheter PDA closure currently proposed for those very small babies.