THE LARGE WINDOW DUCTUS - A SURGICAL TRAP

A rare window type of patent ductus arteriosus is reported that was la rge (15 mm in maximal transverse dimension) but had virtually no lengt h and hence was externally invisible. The smaller aortic isthmus (4 mm in diameter), which was intrapericardial, was mistaken for the ductus and was inadvertently clip-occluded, leading to death. After a specif ic diagnosis is made, the large window ductus should be patched on car diopulmonary bypass with a transpulmonary approach. (C) 1998 by The So ciety of Thoracic Surgeons.