OBJECTIVE: Video-Assisted thoracoscopic surgery has been shown to be a safe and effective method of closing patent ductus arteriosus.We retrospectively studied our series of patients who underwent video-assisted thoracoscopic surgical (VATS) closure of patent ductus arteriosus (PDA) with new modifications.
METHODS: From June 1997 to December 2007, 1700 consecutive patients diagnosed as PDA(mean age:6 years old),were referred to us:and all of them met our inclusion criteria making eligible for VATS procedure. Recently, we have made some minor alterations in our routine methodology, which will be discussed in more detail later. After complete closure of PDA by two titanium clips the extubated patient leaves the Operating Room without a chest tube.
RESULTS: All the pertaining data were collected and analyzed. There were four cases of chylothorax, which were seurgically treated , after one week of close observation. The procedure was changed to thoracotomy in seven patients. Meanwhile, five aditional paients developed transient recurrent laryngeal nerve dysfunction. All cases were re-assessed immediately after the procedure, and followed for more than 10 years by control echocardiography. No significant complication and residual shunt was recorded during the follow-up period. Mean procedure time was about 10+/-2 minutes. All patients were discharged shortly after the procedure (~15 hours).
CONCLUSIONS: This experience indicates that video-assisted thoracoscopic surgery is superior to other techniques of ductal closure, and it is simple, quick, cost-effective, and more comfortable for the patients, in addition to the cosmetic benefits and can be performed as an outpatient procedure.