The PDA is a temporary connection between the vessel pulmonary artery) that leads to the lungs and the vessel that leads to the baby’s body (aorta)

The PDA becomes a problem when it does not close because not enough blood goes to the lungs to get oxygen.

It is common for the PDA to remain open in the premature baby.

If your baby needs surgery, it is performed at Cape Fear Valley Medical Center.  Occasionally, babies are transferred to either Duke University Medical Center or The University Hospital at Chapel Hill for the surgery.

If your baby’s surgery is done at another hospital, as soon as your baby’s condition is stable and the doctors are happy with the baby’s progress, the baby may be returned to Cape Fear Valley Medical Center’s Neonatal Intensive Care Unit.

 This surgery requires a "special surgeon;" one who has developed "special" skills and had extra years of training.  This surgeon is called a cardiothoracic (car-dee-o-thor-as-ick) surgeon.

	We encourage you to come to the NICU and talk with him about your baby's planned surgery.
	We encourage you to visit before and after your baby’s surgery.

You will be asked to sign consent (give permission) for the surgery.

The surgery is done in the hospital’s Operating Room (OR) and your baby is asleep for the surgery.

If your baby has been off the ventilator and the endotracheal tube (ET Tube) has been removed, the Neonatal Nurse Practitioner will re-insert the endotracheal tube (intubate) and place the baby back on the ventilator the day of surgery.

The endotracheal tube remains in place through the surgery and for several hours after surgery.

It is difficult to “guess” how long your baby will remain on the ventilator and have the ET Tube in place after surgery.  Every baby is different.

	We will remove the ET Tube and take your baby off the ventilator as soon as he/she is awake and able to breathe on his/her own.
	The Neonatologist and/or NNP will talk with you about this when your baby comes back from surgery.

We will move your baby from their isolette to the open bed warmer he/she was on when they were first admitted to the NICU. 

When the surgeon and OR staff are ready for your baby, we will move your baby to the OR on his/her bed.

	One of the neonatologists, the baby's nurse, and a respiratory therapist will go with your baby to the OR
	After the surgery, your baby will return to the NICU

The surgeon makes a small incision in the baby’s left chest and “ties off” the PDA.  The surgeon does not have to open the heart to correct this blood flow.  If there is no other defect, this restores the blood flow to normal.

Surgery takes about 2 hours.

Before your baby leaves the OR, the surgeon will put a chest tube in the baby’s left chest and connect it to a container.

	The chest tube drains air and fluid that may have collected in their chest during surgery.
	The container collects the air/fluid that has drained out.
	The chest tube remains in place until we are sure all the air/fluid has drained out and is not going to collect again.
	Putting the chest tube in during surgery does not hurt the baby he/she is still asleep.
	Removing the chest tube is a little uncomfortable but, if needed, we can give the baby some medicine.

Right after surgery, some infants look pale. They may appear slightly “puffy,” and some may require a blood transfusion.  All of these things will get better over time.

The surgeon will come to the NICU after surgery and talk with you about your baby’s surgery.  We encourage you to ask any questions you may have.

We also encourage you to visit before and after your baby’s surgery.  If you are unable to visit, please call daily, and the staff will give you an update on your baby.