DIVISION of a patent ductus arteriosus in skilled hands carries a very low morbidity and mortality. Vascular clamps have been improved during the past decade, and when properly applied, slipping or tearing of the vessel wall is rare. We have felt that the "toe" of the clamp is less secure than the "heel." For this reason, to obtain more purchase of the vascular tissue away from the "toe" of the clamp, we have been applying a Satinsky-type clamp on the aortic side of the ductus (Figure). This clamp may be applied, as shown, or in an opposite direction. The aorta is closed by suturing the aortic wall and not the ductus itself, as is the case when a straight vascular clamp is applied. Occasionally, the curved clamp is more difficult to apply than a straight one, but we feel that the added security justifies its use.
This study was aided
Tsuji HK, Redington JV, Harold J. A Technique for Division of the Patent Ductus Arteriosus. Arch Surg. 1968;96(1):85. doi:10.1001/archsurg.1968.01330190087019