Abstract
ABSTRACT
This article presents our results with video-assisted thoracoscopic interruption of a patent ductus arteriosus. From 1994 to 1996, this technique was used on 7 patients in our institute. Their ages ranged from 0.9 to 5.0 years old with a mean of 2.4 years old. Their body weights ranged from 6.3 to 20.0 kg with a mean of 11.6 kg. Preoperative cardiac catheterization showed that the average Pp/Ps was 0.4, Qp/Qs was 2.1, and left to right shunt was 49%. The diameter of the vessels ranged from 3.0 to 7.0 mm with a mean of 4.8 mm based on preoperative angiograms. Patients were placed in a right lateral position. A thoracoscope was introduced through the 7th intercostal space in the posterior axillary line. While watching with the thoracoscope, two or three small thoracostomies were made for surgical instruments and the clip applier. An incision was made in the mediastinal pleura over the proximal descending aorta. The descending aorta and ductus were dissected free and the recurrent laryngeal nerve was separated anteriorly. The vessel was looped with a tape and was interrupted with two titanium clips. A chest drain was placed. The operating time averaged 240 min. Patients were extubated in the operating room and the drain was removed on the Postoperative Day 1 in all patients. One patient had hoarseness for 2 weeks but no other complications were noted. The mean hospital stay was 9.1 days. The video-assisted thoracoscopic interruption of the patent ductus arteriosus is a safe and useful technique.
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