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Ann Thorac Surg 2005;79:1828
© 2005 The Society of Thoracic Surgeons

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Correspondence

Patent Ductus Arteriosus in Neonates and New Approaches: Reply

Department of Surgery, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirao Preto, SP 14048-900, Brazil

(E-mail: wvvicent{at}fmrp.usp.br).

To the Editor:

I compliment Villa and coauthors for devising a novel surgical approach for PDA closure in neonates.

Notwithstanding their criticism regarding our recently published technique [1], we have already performed 108 operations with good short- and long-term results. The surgical operative time has progressively came down, and at present the operation takes usually less than 10 minutes to be completed. The prone position has been well tolerated, and albeit parietal pleura breakthrough sometimes happened, visceral pleura lacerations never occurred, thus completely avoiding pleural drainage in our cases.

The small posterior surgical scar is well accepted by the parents, particularly the parents of baby girls, as well as by the pediatric cardiologists and by the children once they grow older. Another striking feature of the posterior Q-tip operation comes from the preservation of thoracic cage anatomy. As a matter of fact, it would be hard to guess, from the postoperative chest radiography, which side of the thorax was entered.

In summary, Villa and coauthors, like ourselves, made a move away from the classic lateral thoracotomy incision, although in an opposite direction. In accordance to Cooley's motto "modify, simplify, apply," time will tell which operation becomes preferred on the basis of safety, simplicity, and cosmesis.

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1. Vicente WVA, Rodrigues AJ, Ribeiro PJF, et al. Dorsal minithoracotomy for ductus arteriosus clip closure in premature neonates Ann Thorac Surg 2004;77:1105-1106.[Abstract/Free Full Text]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Walter V.A. Vicente Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Vicente, W. V.A. Search for Related Content PubMed Articles by Vicente, W. V.A. Related Collections Congenital - acyanotic Related Article