Abstract
Surgical closure of a patent ductus arteriosus (PDA) continues to be a frequent procedure among extremely preterm infants. Recent evidence indicates surgical closure is associated with worse outcomes than after medical closure. Left vocal fold paralysis is a known complication of this surgery, but there is little information available on the impact of this specific complication on long-term outcomes of these infants. In this case series, we describe the clinical course of three sets of multiple births, in which at least one infant underwent surgical closure of the PDA and subsequently developed feeding and/or breathing difficulties due to left vocal fold paralysis, and compare to their siblings who did not sustain this complication. The case series suggests that some long-term morbidities associated with surgical closure of the PDA may be attributable to this specific complication.