VIDEO-THORACOSCOPIC SURGICAL INTERRUPTION OF PATENT DUCTUS-ARTERIOSUS- ROUTINE EXPERIENCE IN 332 PEDIATRIC CASES

Objective: Pediatric video-assisted thoracic surgery closure of patent ductus arteriosus can now be performed on a routine basis. We review here our entire experience with this technique. Methods: Three hundred and thirty two consecutive patients underwent video-assisted closure of patent ductus arteriosus from September 1991 to September 1996, Ind ications were symptomatic ductus or failure of closure in older childr en. All complications were carefully noted, as well as intensive care unit stay, and operating room time. Results: Patients were divided in three age groups: less than 6 months (101 patients, 31%), 6-48 months (179 patients, 54%), greater than 48 months (52 patients, 16%). The me an weight was 12.6 kg (range 1.2-65 kg). Associated cardiac anomalies were atrial septal defect (3), ventricular septal defect (5), anomalou s pulmonary venous return (1). Six patients had a residual shunt follo wing video-assisted interruption. Five patients had successful immedia te clip repositioning (three via video-assisted interruption, two via thoracotomy). One patient continued to have a small shunt, which is fo llowed medically. Complications included recurrent laryngeal nerve dys function in six patients (1.8%) (five transient, one persistent). Mean operating time was 20 +/- 1.5 mn and hospital stay averaged 48 h (> 6 months), 72 h (< 6 months). Conclusions: Interruption of patent ductu s can be safely performed by video-assisted technique with minimal mor bidity and no mortality. It can be performed in all age group with min imal hospital stay. (C) 1997 Elsevier Science B.V.