[A new video-assisted thoracoscopic surgical interruption of patent ductus arteriosus]

A new video-assisted thoracoscopic surgery was applied to patients with patent ductus arteriosus (PDA). After the ductus was carefully dissected and exposed, two or one titanium clips which were 11 mm in length were used to interrupt the ductus completely. Eight patients with PDA were successfully treated by the new technique between July 1992 and September 1993, which was the first successful series in Japan. Mean age was 4.3 years (range 1.7 approximately 6.7 years) and mean weight was 15.6 kg (range 10.0 approximately 24.0 kg). All patients had immediate complete PDA closure after the procedure which was proved to be successful by an esophageal stethoscope and color doppler echocardiogram. One patient had mild left recurrent laryngeal nerve dysfunction which was completely cured on 7th postoperative day. There were no other complications and the usual hospital stay was 4 or 5 days. No residual PDA shunt in all cases was revealed by color doppler echocardiogram during follow-up periods (range 3 approximately 12 months). 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 technique indicated for smaller children and premature infants.