Abstract
From June 1997 to October 2000, 300 consecutive patients (mean age, 6 years) with patent ductus arteriosus recognized by echocardiography and/or cardiac catheterization underwent video-assisted thoracoscopic surgery. Under general anesthesia, three 5-mm holes were made in the left thoracic wall. A video camera and specialized surgical devices were introduced. The ductus was dissected and 2 titanium clips were applied for complete closure of the ductus. Exclusion criteria were: diameter of the ductus > 9 mm; complicated patent ductus arteriosus (aneurysm formation, endocarditis, or calcification); and pleural adhesion or a previous left-sided thoracic operation. All cases were reassessed immediately after the procedure, and followed up by echocardiography. No residual shunt was recorded. The procedure was changed to a thoracotomy in 3 adults due to inappropriately dilated canal (> 9 mm); 2 others developed transient recurrent laryngeal nerve dysfunction. Mean procedure time was 20 ± 2 minutes. All patients were discharged shortly after the procedure (at approximately 20 hours). The results indicate that video-assisted thoracoscopic surgery was superior to other techniques of ductal closure.
Get full access to this article
View all access options for this article.