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Thoracoscopic closure of the patent arterial duct

Published online by Cambridge University Press:  20 January 2005

Vladimiro L Vida ,
Maurizio Rubino ,
Tomaso Bottio ,
Massimo A. Padalino ,
Ornella Milanesi ,
Demetrio Pittarello  and
Giovanni Stellin
Vladimiro L Vida
Affiliation:
Department of Cardiovascular Surgery, Paediatric Cardiac Surgery Unit, University of Padua-Medical School, Padova, Italy
Maurizio Rubino
Affiliation:
Department of Cardiovascular Surgery, Paediatric Cardiac Surgery Unit, University of Padua-Medical School, Padova, Italy
Tomaso Bottio
Affiliation:
Department of Cardiovascular Surgery, Paediatric Cardiac Surgery Unit, University of Padua-Medical School, Padova, Italy
Massimo A. Padalino
Affiliation:
Department of Cardiovascular Surgery, Paediatric Cardiac Surgery Unit, University of Padua-Medical School, Padova, Italy
Ornella Milanesi
Affiliation:
Department of Paediatrics, University of Padua-Medical School, Padova, Italy
Demetrio Pittarello
Affiliation:
Department of Cardiovascular Surgery, Paediatric Cardiac Surgery Unit, University of Padua-Medical School, Padova, Italy
Giovanni Stellin
Affiliation:
Department of Cardiovascular Surgery, Paediatric Cardiac Surgery Unit, University of Padua-Medical School, Padova, Italy
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Abstract

Video assisted thoracoscopic surgery for closure of the persistently patent arterial duct is an effective answer to the modern effort of seeking repair of congenital cardiac malformations with minimally invasive techniques.

Between June, 1994, and December, 2002, 150 consecutive patients with an echocardiographic diagnosis of isolated patency of the arterial duct were referred to our Institution for video assisted thoracoscopic closure. The median age at the time of operation was 45 months, with a range from 3 to 161 months, and mean weight was 18 kg, with a range from 4.2 to 73 kg. Video assisted closure was possible in 139 patients (93%). The mean operative time was 37 min, with a range from 14 to 89 min. In the remaining 11 patients (7%), seen early in our experience, we converted to a mini-thoracotomy to achieve closure. In no instance did we encounter major haemorrhage requiring blood transfusion, and there were no hospital deaths. The mean period of stay in hospital was less than 24 h in 61 patients, less than 48 h in 88 patients seen earlier in our experience, and 21 days in 1 patient because of a persistent chylothorax. Other complications included palsy of the left recurrent laryngeal nerve in 1 patient, with partial regression at 6 months follow-up.

We conclude that closure of the arterial duct by video-assisted thoroscopy combines the advantages of safe and complete extraluminal occlusion with an excellent clinical and aesthetic result, minimal postoperative pain, and short stay in hospital at low cost.

Keywords

Patent ductus arteriosusthoracoscopic surgeryminimally invasive
Type
Original Article
Information
Cardiology in the Young , Volume 14 , Issue 2 , April 2004 , pp. 164 - 167
Copyright
© 2004 Cambridge University Press

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References

Backer CL, Mavroudis C. Congenital Heart Surgery Nomenclature and Database Project: Patent Ductus Arteriosus, Coarctation of the Aorta, Interrupted Aortic Arch. Ann Thorac Surg 2001; 69: S298–S307.Google Scholar
Rotthenberg SS, Chang JHT, Toews WH, Washington RI. Thoracoscopic closure of patent ductus arteriosus: a less traumatic and more cost-effective technique. J Pediatr Surg 1995; 7: 1057–1060.Google Scholar
Gross RE, Hubbard JP. Surgical ligation of a patent ductus arteriosus: report of first successful case. JAMA 1939; 112: 729–731.Google Scholar
Laborde F, Narhomme P, Karam J, Batisse A, Bourel P, St. Maurice MO. A new videoassisted surgical technique for interruption of PDA in infants and children. J Thorac Cardiovasc Surg 1993; 105: 278G–280G.Google Scholar
Laborde F, Folliguet TA, Etienne PY, Carbognani D, Batisse A, Petrie J Video-thoracoscopic surgical interruption of patent ductus arteriosus. Routine experience in 332 pediatric cases. Eur J Cardiothorac Surg 1997; 11: 1052–1055.Google Scholar
Portsmann W, Wierny L, Warnake H, et al. Catheter closure of patent ductus arteriosus: 62 cases treated without thoracotomy. Radiol Clin North Am 1971; 9: 203–218.Google Scholar
Fan LL, Campbell DN, Clarke DR, Washington RL, Fix EJ, White CW. Paralyzed left vocal cord associated with ligation of patent ductus arteriosus. J Cardiovasc Surg 1989; 98: 611–613.Google Scholar
Jaureguizar E, Vazquez J, Murcia J, Diez Pardo JA. Morbid musculoskeletal sequelae of thoracotomy for tracheoesophageal fistula. J Pediatr Surg 1985; 20: 511–514.Google Scholar
Rothenberg SS, Pokorny WJ. Experience with a total muscle-sparing approach for thoracotomies in neonates, infants, and children. J Pediatr Surg 1992; 27: 1157–1160.Google Scholar
Dajczman E, Gorgan A, Kreisman H, Wolkove N. Long term post-thoracotomy pain. Chest 1991; 99: 270–274.Google Scholar
Hines MHH, Bensky AS, Hammon JW, Pennington DG. Video-assisted thoracoscopic ligation of patent ductus arteriosus. Safe and outpatient. Ann Thorac Surg 1998; 66: 853–859.Google Scholar
Hosking MC, Benson LN, Musewe H, Dyck JD, Freedom RM. Transcatheter occlusion of the persistently patent ductus arteriosus: forty-month follow-up and prevalence of residual shunting. Circulation 1991; 84: 2313–2317.Google Scholar
Tynan M. Transcatheter occlusion of persistent arterial duct. Report of the European Registry. Lancet 1992; 340: 1062–1066.Google Scholar