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Non-Intubated Video-Assisted Thoracoscopic Surgery
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Ventilation strategy for video-assisted thoracoscopic clipping of patent ductus arteriosus in children

K Muralidhar1, D P Shetty

  • 1Manipal Heart Foundation, Bangalore, India. mhfbg@giasbg01.vsnl.net.in

Paediatric Anaesthesia
|December 21, 2000
PubMed

Insights

Video-assisted thoracoscopic surgery for patent ductus arteriosus (PDA) in children is feasible. Low tidal volume-high frequency ventilation offers safe and effective oxygenation during this minimally invasive procedure.

Area of Science:

  • Pediatric Cardiac Surgery
  • Minimally Invasive Surgery
  • Thoracic Surgery

Background:

  • Video-assisted endoscopic techniques offer reduced trauma in adult surgery.
  • Application in pediatric congenital heart disease, specifically patent ductus arteriosus (PDA), remains limited.

Purpose of the Study:

  • To evaluate the safety and efficacy of video-assisted thoracoscopic (VAT) patent ductus arteriosus (PDA) clipping in children.
  • To compare respiratory management strategies during VATS PDA repair.

Main Methods:

  • Forty pediatric patients with PDA were divided into two groups for VATS.
  • Group A: Right main stem bronchial intubation.
  • Group B: Low tidal volume-high frequency ventilation (Siemens 900C ventilator).

Main Results:

  • Mean SpO2 was significantly lower in Group A (90%) compared to Group B (96.8%).
  • Surgical convenience was comparable between the two groups.
  • Low tidal volume-high frequency ventilation demonstrated safe oxygenation levels.

Conclusions:

  • Low tidal volume-high frequency ventilation is an acceptable and safe respiratory strategy for pediatric patients undergoing VATS PDA repair.
  • Video-assisted thoracoscopic patent ductus arteriosus clipping is a viable minimally invasive option for children.

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