Video-assisted thoracoscopic ligation of patent ductus arteriosus: safe and outpatient.
BACKGROUND
Minimally invasive techniques for interruption of patent ductus arteriosus have been reported, but are in use at only a few centers. We examined our series of patients who underwent thoracoscopic patent ductus arteriosus ligation.


METHODS
We reviewed 59 consecutive patients, age 6 days to 50 years, weighing 640 g to 62 kg, who underwent video-assisted placement of a stainless steel clip across the patent ductus arteriosus.


RESULTS
Thirty-eight nonneonates and 21 neonates (18 were < or =1,500 g) underwent video-assisted thoracic surgery for patent ductus arteriosus closure with intraoperative echocardiographic confirmation in nonneonates. There were no residual shunts, transfusions, chylothoraces, or significant pneumothoraces. Four were converted to thoracotomy, 3 for anatomic variances, and 1 for coagulopathy. Thirty-six of 38 nonneonate patients stayed less than 24 hours; 18 were discharged the evening of the operation. Two were admitted, one after thoracotomy, and one for a small mucosal intubation injury. No others required a chest tube. There were two recurrent nerve injuries. All neonates survived, and were extubated.


CONCLUSIONS
Video-assisted thoracoscopic ductus closure is a safe, reliable technique and can be performed as an outpatient procedure in nonneonate patients.
Department of Cardiothoracic Surgery, Wake Forest University Baptist Medical Center and Brenner Children's Hospital, Winston-Salem, North Carolina 27157, USA. mhines@wfubmc.edu
M H
MH
Hines
A S
AS
Bensky
J W
JW
Hammon
D G
DG
Pennington
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004374:Ductus Arteriosus, Patent / Q000601:surgery*; D004724:Endoscopy; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008026:Ligation; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013906:Thoracoscopy; D016896:Treatment Outcome; D014741:Video Recording