An innovative thoracoscopic surgery for patent ductus arteriosus: a Japanese first case report

A 5-year-old girl with patent ductus arteriosus (PDA) was successfully treated by thoracoscopic surgery, which was the first successful case in Japan. The operation was carried out under general anesthesia with the usual endotracheal intubation. Short trocars were inserted through the left intercostal spaces to introduce a flexible video thoracoscope and adequate surgical instruments. After the ductus was carefully dissected and exposed, two titanium clips, 11 mm in length, were applied to interrupt the ductus completely. The continuous heart murmur of PDA disappeared, as confirmed by an esophageal stethoscope. Postoperative course was uneventful and the patient was discharged on the 6 postoperative day. Eighteen months after surgery, no residual PDA shunt was revealed by doppler echocardiogram. The advantages of thoracoscopic surgery for PDA are less postoperative pain and discomfort, early recovery and short hospital stay, and cosmetic preservation. Availability of smaller sized surgical instruments should allow smaller children or newborns with PDA to be treated with this method.