Two premature infants who had surgical ligation of their patent ductus arteriosus are described. These infants initially did well postoperatively but then developed congestive heart failure. Both infants had echocardiographic evidence of recurrence of their patent ductus arteriosus. One of the infants required a repeat ligation procedure. It is important to continue to monitor premature infants for the return of clinical signs of a patent ductus arteriosus after surgical ligation.

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