In 1938 Gross performed the first successful ligation of a patent ductus arteriosus. Since that time techniques have varied1 and been perfected. Medical and surgical authors have discussed the radical and conservative treatment of this anomaly.2 Few corrections of this anomaly have been successfully carried out in the premature infant with secondary complications.
Most authors prefer to operate on the child free of cardiac failure, infection, and the technical hazard of extremely small size. But, if these adverse conditions exist and are medically irreversible, then operative intervention should be attempted.
The following case is an example of the successful repair of a patent ductus arteriosus in a premature infant with penumonitis and medically uncontrollable congestive heart failure. The patient weighed 3 lb 2 oz (1,417 gm) at the time of surgery. This case is believed to represent the smallest child ever to be successfully repaired.3