title: Video-assisted thoracoscopic patent ductus arteriosus closure in 2,000 patients.
abstract: Video-assisted thoracoscopic surgery has proved to be a safe and effective method with low complication and high success rates. From 1997 to 2008, 2,000 consecutive patients with patent ductus arteriosus underwent closure of the ductus with 2 titanium clips via a video-assisted thoracoscopic technique. Complete closure was confirmed using our handmade intraesophageal stethoscope. The mean age was 5.2 years, and mean weight was 9.8 kg. One death was reported 1 month after surgery, due to sepsis during hospitalization for chylothorax treatment. The procedure was converted to an emergency thoracotomy in one case, due to ductal wall rupture. There were 4 late residual shunts treated via thoracotomy. We observed transient laryngeal nerve dysfunction in 14 patients. All patients were reassessed by postoperative echocardiography. The mean procedure (skin-to-skin) time was 10 ± 2 min, and hospitalization was 21 h. This study indicates that video-assisted thoracoscopic closure of patent ductus arteriosus is a safe, simple, and cost-effective method with low complication and high success rates. Furthermore, the cosmetic benefits make it appropriate as an out-patient procedure.
authors.affiliation: Department of Cardiac Surgery, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. mhnezafati@yahoo.com
authors.forename: Mohammad Hassan
authors.initials: MH
authors.lastname: Nezafati
authors.forename: Ghasem
authors.initials: G
authors.lastname: Soltani
authors.forename: Hassan
authors.initials: H
authors.lastname: Mottaghi
authors.forename: Mohsen
authors.initials: M
authors.lastname: Horri
authors.forename: Pouya
authors.initials: P
authors.lastname: Nezafati
mesh_terms: D000293:Adolescent; D000328:Adult; D006328:Cardiac Catheterization; D002648:Child; D002675:Child, Preschool; D004374:Ductus Arteriosus, Patent / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D018618:Echocardiography, Doppler, Color; D004867:Equipment Design; D005260:Female; D006801:Humans; D007223:Infant; D007492:Iran; D008297:Male; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery; D012086:Reoperation; D013525:Surgical Instruments; D020775:Thoracic Surgery, Video-Assisted / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D013908:Thoracotomy; D013997:Time Factors; D014025:Titanium; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D014025:Titanium