When is surgery needed for a child with a?patent foramen ovale?and a patent ductis arteriosus?

PFO vs PDA: A hemodynamically significant PDA (with excess lung flow in a newborn) is usually closed by surgical ligation (entering from left back with slight incision and tying off pda). Nothing is usually done about a pfo as they are insignificant. If latter is large (or an asd) it may be closed by surgery or device closure (interventional cardiology).

With symptoms: In the majority of cases these openings close spontaneously shortly after birth. When they remain open and interfere with adequate oxygenation and/or ventilation, exercise tolerance, etc., then surgery may be indicated. Surgery can be done minimally invasive or open.