[Closure of patent ductus arteriosus by video thoracoscopy in 282 children].
Closure of patent ductus arteriosus by video thoracoscopy is a standardised procedure. The authors report their experience of closure of patent ductus arteriosus by video-thoracoscopy from May 1991 to December 1995. The series included 282 patients divided into 3 groups according to age: under 6 months (78 patients, 27.6%), from 6 months to 4 years (135 patients, 42.88%) and over 4 years of age (69 patients, 24.6%) with an average weight of 12.6 kg (range: 1.2 to 65 kg). Symptomatic pulmonary hypertension was observed in 39 cases and 9 children had associated intracardiac malformations (ostium secundum: 3; ventricular septal defect: 5; abnormal pulmonary venous drainage: 1) which were not corrected. The technique consisted of placing two titanium clips in position under video-thoracoscopy to close the ductus. An echo performed immediately afterwards confirmed closure of the ductus. The main complications were: persistence of a shunt (4 cases) at the beginning of our experience requiring immediate reoperation by video-thoracoscopy in 3 cases and by thoracotomy in one case; left recurrent laryngeal nerve palsy in 6 cases (2.1%) with regression in 5 and persistence in one case; one case of postoperative chylothorax which regressed rapidly. There were no fatalities or haemorrhages and no blood transfusions were required in this series. The average operating time was 20 +/- 15 minutes and the duration of hospital stay around 48 hours when the patients were over 6 months old and 72 hours when less than 6 months of age. Video-thoracoscopic closure of patent ductus arteriosus is rapid, safe, economical, it provides excellent results and may be used in children of all ages.
Laborde
F
F
Department de chirurgie cardiaque, institut mutualiste Montsouris, Paris.
Folliguet
T
T
Batisse
A
A
Dibie
A
A
da Cruz
E
E
Carbognani
D
D
D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D004374:Ductus Arteriosus, Patent / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D018618:Echocardiography, Doppler, Color; D004724:Endoscopy / Q000009:adverse effects / Q000379:methods*; D006330:Heart Defects, Congenital / Q000150:complications; D006801:Humans; D007223:Infant; D007902:Length of Stay; D011859:Radiography; D061226:Recurrent Laryngeal Nerve Injuries; D013528:Surgical Staplers; D013906:Thoracoscopy; D016896:Treatment Outcome; D014741:Video Recording
Fermeture du canal artériel par vidéo-thoracoscopie chez 282 enfants.