[An innovative thoracoscopic surgery for patient ductus arteriosus--a Japanese first case report]

A five-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 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 which were 11 mm in length were applied to interrupt the ductus completely. The continuous heart murmur of PDA was confirmed to disappear by an esophageal stethoscope. Postoperative course was uneventful and the patient was discharged on 6 postoperative day. No residual PDA shunt was revealed by doppler echocardiogram 8 months after surgery. 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 this method indicated for smaller children or newborns with PDA.