LIGATION of the patent ductus arteriosus was first proposed in 1907, by Munro.1 He had seen a healthy infant die of this cardiac anomaly. Based on the observations at autopsy and other anatomic studies, he described in detail an operation for ligation of the ductus, although he himself had never performed one on the living. He stated, in general, "The one cardiac valvular lesion which is relatively speaking superficial" could be attacked "by a short surgical route"; the ductus "could easily be surrounded with ligature." He "doubted whether it would materially hasten a fatal issue in case the diagnosis were not confirmed." The operation was advised for failure of the circulation.
Not until thirty-one years later was the first attempt to ligate the patent ductus arteriosus reported (Graybiel, Strieder and Boyer).2 Their patient had superimposed subacute bacterial endarteritis. The purpose of the operation was to destroy the bacterial