In this retrospective study, we evaluated the effect of single versus multiple courses of indomethacin on the timing of surgical ligation, duration of oxygen dependency after indomethacin treatment and surgical ligation, rehospitalization, and neonatal morbidity parameters. Between 2000 and 2006, 29 infants who underwent surgical ligation of patent ductus arteriosus (PDA) were included in the study group. Twelve infants received one course and 14 infants received two or more courses of indomethacin. One course and multiple courses did not affect the ligation age statistically (p=0.486). There was also no significant difference between one course and multiple courses of indomethacin on duration of oxygen dependency after indomethacin and post-ligation or on duration of mechanical ventilation after surgery. There was no statistically significant difference in morbidity parameters. Postoperative mortality in surgically ligated patients was 3% at 7 days, 10% at 30 days and 13% beyond day 30 up to hospital discharge. We concluded that early surgical ligation of PDA is needed if there is no response to medical treatment. Although multiple courses of indomethacin treatment before surgical ligation appear not to have any significant adverse effects, it should be considered that the potential for adverse effects exists.

Keywords: patent ductus arteriosus, indomethacin, surgical ligation