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Patent Ductus Arteriosus
Everything in the library about patent ductus arteriosus — built automatically from the recorded discussions that name it
Educational content from recorded physician discussions — not medical advice. Always talk to your child's care team about your child's situation.
Content of this collection
Surgical Management
1 item
PDA ligation narrated
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Surgical content by Dr. Steve Rothenberg — Thoracic Surgery
video6:24 · May 2026
Evidence & Research
2 items
Expectant Management or Early Ibuprofen for Patent Ductus Arteriosus
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Another article you should know by Cecilia Gigena
"Expectant Management or Early Ibuprofen for Patent Ductus Arteriosus"
Authors: Tim Hundscheid, M.D., Wes Onland, M.D., Ph.D., Elisabeth M.W. Kooi, M.D., Ph.D., Daniel C. Vijlbrief, M
video1:14 · Aug 2023
Manejo expectante o ibuprofeno temprano para el tratamiento del conducto arterioso persistente
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Nuevo articulo que tenes que conocer por Cecilia Gigena
"Manejo expectante o ibuprofeno temprano para el tratamiento del conducto arterioso persistente"
Autores: Tim Hundscheid, M.D., Wes Onland, M.D., Ph.D., Elisabeth M.W. Kooi, M.D.
video · Aug 2023
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Every expert statement below comes from the recorded discussions, with its speaker and moment.
Expectant Management or Early Ibuprofen for Patent Ductus Arteriosus
A multi-center non-inferiority trial compared preterm infants treated with expectant management versus early ibuprofen for PDA
host_summaryCecilia Gigena0:09 ↗
The trial enrolled 273 infants total
host_summaryCecilia Gigena0:22 ↗
136 infants were treated with expectant management and 137 with early ibuprofen
host_summaryCecilia Gigena0:25 ↗
In the expectant management group, 17.6% developed necrotizing enterocolitis
host_summaryCecilia Gigena0:31 ↗
In the expectant management group, 33% developed bronchopulmonary dysplasia
host_summaryCecilia Gigena0:31 ↗
In the expectant management group, the death rate was 14%
host_summaryCecilia Gigena0:31 ↗
In the ibuprofen group, 15.4% developed necrotizing enterocolitis
host_summaryCecilia Gigena0:43 ↗
In the ibuprofen group, 50% developed bronchopulmonary dysplasia
host_summaryCecilia Gigena0:43 ↗
In the ibuprofen group, the death rate was 80%
host_summaryCecilia Gigena0:43 ↗
Expectant management is non-inferior to early ibuprofen in preterm patients with PDA
host_summaryCecilia Gigena1:01 ↗
PDA ligation narrated
The infant undergoing thoracoscopic PDA ligation weighs 2 kg.
clinical0:02 ↗
The patient is placed in a modified prone position with the left side elevated approximately 30 degrees for thoracoscopic PDA ligation.
clinical0:20 ↗
Port placement includes a 4 mm scope slightly behind and above the scapula tip, and 3 mm and 5 mm working ports.
clinical0:50 ↗
Simple insufflation is used to collapse the lung; single lung ventilation is not required, although it can be used in larger patients.
clinical1:20 ↗
A 3 mm port is initially placed in the posterior axillary line in approximately the fifth intercostal space to aid dissection, later changed to a 5 mm port for clip placement.
clinical1:50 ↗
It is important not to use monopolar cautery near the ductus because of the risk of injuring the recurrent laryngeal nerve.
clinical2:30 ↗
Creating a pleural flap over the mid portion of the aorta helps safely retract the vagus and recurrent laryngeal nerves out of the way.
clinical3:10 ↗
In this case, the ductus is large, approximately two-thirds the diameter of the aorta.
clinical3:50 ↗
Careful blunt dissection is used to dissect behind the ductus to avoid injuring the recurrent laryngeal nerve or tearing the ductus.
clinical4:10 ↗
Gentle spreading with the 3 mm vessel sealer is an excellent way to achieve adequate mobilization of the ductus.
opinion4:30 ↗
It is generally recommended to spread in the direction of the ductus to eliminate the risk of tearing it.
clinical4:55 ↗
Test clamping of the ductus is performed with a distal pulse oximeter on the foot to ensure the correct structure is being occluded.
clinical5:20 ↗
It is very important to have proximal and distal monitoring during PDA ligation.
clinical5:40 ↗
A single 5 mm endoclip is placed on the ductus after the 3 mm trocar is changed to a 5 mm trocar.
clinical5:50 ↗
It is important to deploy the clip into the clip applier before placing it onto the duct, as deploying while already around the duct can force the tissue away.
clinical6:05 ↗
The clip application resulted in complete occlusion of the ductus.
clinical6:20 ↗
The patient had evidence of interstitial lung disease on CT scan, and the pulmonologist requested a lung biopsy for better evaluation.
clinical6:30 ↗
A 5 mm stapler is appropriate in size for a 2 kg infant for performing a wedge lung biopsy.
clinical7:00 ↗
Care must be taken to ensure tissue is far enough into the stapler so the staple line reaches across the entire line of the resected specimen.
clinical7:20 ↗
A single firing of the stapler is all that is needed for the wedge biopsy.
clinical7:40 ↗
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