A patent ductus arteriosus (PDA) can be closed using various procedures, including transcatheter closure, video-assisted thoracoscopic surgery, and conventional surgery with division and suture. These procedures are feasible for treatment of PDA in a child, but are believed to be challenging when employed in an adult. The main danger is intraoperative bleeding. With a hemorrhage, inadvertent ductus damage/perforation during the isolated ductus, the traditional surgical approach was accomplished with considerable difficulty. This study reports a new procedure for these adult patients using an intrapericardial approach to the ductus. The operation was done as an emergency salvage procedure. Based on the results from the 4 cases of PDA, such technique is found to be simple, safe, and effective.