title: Minimally invasive thoracoscopic closure versus thoracotomy in children with patent ductus arteriosus.
abstract: Patent ductus arteriosus (PDA) is one of the most common congenital heart defects. Once diagnosed, an immediate pharmacologic or invasive treatment should be performed. The purpose of this work was to evaluate the safety and efficacy of surgical PDA ligation in children using video-assisted thoracoscopic surgery (VATS) in comparison with a conventional muscle-sparing posterolateral thoracotomy technique (MSPLT).
  
  
  
  In this single-center, retrospective study 173 children qualified for surgical PDA closure were enrolled. Patients were divided according to their weight and type of surgery performed. The groups consisted of patients operated through thoracotomy (54%) or VATS (46%). Operative characteristics, cosmetic effect, postoperative complications and long-term survival were evaluated.
  
  
  
  Regardless of weight, fewer complications were noted in children after thoracoscopic clipping. Fifteen VATS patients required intraoperative conversion to thoracotomy; however, adverse sequelae were not observed. Aesthetics seemed to be the major complaint after conventional surgery. We did not observe any statistically significant differences in the long-term survival between both groups.
  
  
  
  Both techniques were shown to be safe and effective. Unsuccessfully performed thoracoscopic surgeries were safely converted to conventional thoracotomy. VATS, being a less invasive approach, leads to a better aesthetic effect and lower surgical complication rate.
authors.affiliation: Department of Cardiac Surgery, Medinet Heart Center Ltd, Wroclaw, Poland. Electronic address: tomekstankowski89@gmail.com.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Stankowski
authors.affiliation: Department of Cardiac Surgery, Medinet Heart Center Ltd, Wroclaw, Poland.
authors.forename: Sleiman Sebastian
authors.initials: SS
authors.lastname: Aboul-Hassan
authors.affiliation: Department of Cardiac Surgery, Medinet Heart Center Ltd, Wroclaw, Poland; Department of Cardiac Surgery, Wroclaw Medical University, Wroclaw, Poland.
authors.forename: Jakub
authors.initials: J
authors.lastname: Marczak
authors.affiliation: Department of Cardiac Surgery, Medinet Heart Center Ltd, Wroclaw, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Szymanska
authors.affiliation: Department of Cardiac Surgery, Medinet Heart Center Ltd, Wroclaw, Poland.
authors.forename: Cyprian
authors.initials: C
authors.lastname: Augustyn
authors.affiliation: Department of Cardiac Surgery, Medinet Heart Center Ltd, Wroclaw, Poland; Department of Cardiac Surgery, Warsaw Medical University, Warsaw, Poland.
authors.forename: Romuald
authors.initials: R
authors.lastname: Cichon
mesh_terms: D004374:Ductus Arteriosus, Patent / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D011044:Poland / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D020775:Thoracic Surgery, Video-Assisted / Q000401:mortality*; D013908:Thoracotomy / Q000401:mortality*
keywords: Patent ductus arteriosus; Surgical ligation; Thoracotomy; Video-assisted thoracoscopy