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Ann Thorac Surg 1998;66:853-859
© 1998 The Society of Thoracic Surgeons
a Department of Cardiothoracic Surgery, Wake Forest University Baptist Medical Center and Brenner Children’s Hospital, Winston-Salem, North Carolina, USA
b Department of Pediatric Cardiology, Wake Forest University Baptist Medical Center and Brenner Children’s Hospital, Winston-Salem, North Carolina, USA
Address reprint requests to Dr Hines, Department of Cardiothoracic Surgery, Wake Forest University Baptist Medical Center, Medical Center Blvd, Winston-Salem, NC 27157
e-mail: (mhines{at}wfubmc.edu)
Presented at the Forty-fourth Annual Meeting of the Southern Thoracic Surgical Association, Naples, FL, Nov 6–8, 1997.
Background. Minimally invasive techniques for interruption of patent ductus arteriosus have been reported, but are in use at only a few centers. We examined our series of patients who underwent thoracoscopic patent ductus arteriosus ligation.
Methods. We reviewed 59 consecutive patients, age 6 days to 50 years, weighing 640 g to 62 kg, who underwent video-assisted placement of a stainless steel clip across the patent ductus arteriosus.
Results. Thirty-eight nonneonates and 21 neonates (18 were 
1,500 g) underwent video-assisted thoracic surgery for patent ductus arteriosus closure with intraoperative echocardiographic confirmation in nonneonates. There were no residual shunts, transfusions, chylothoraces, or significant pneumothoraces. Four were converted to thoracotomy, 3 for anatomic variances, and 1 for coagulopathy. Thirty-six of 38 nonneonate patients stayed less than 24 hours; 18 were discharged the evening of the operation. Two were admitted, one after thoracotomy, and one for a small mucosal intubation injury. No others required a chest tube. There were two recurrent nerve injuries. All neonates survived, and were extubated.
Conclusions. Video-assisted thoracoscopic ductus closure is a safe, reliable technique and can be performed as an outpatient procedure in nonneonate patients.
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