A safe technique of thoracoscopic clipping of patent ductus arteriosus in children.
To present a modified and safe technique of thoracoscopic clipping of patent ductus arteriosus (PDA) in children and its early outcomes. Patients are anesthetized, ventilated via single-lung ventilation, and placed in a right lateral position. The surgeon and the assistant stand at the patient's feet, and a monitor is placed at the patient's head. The ductus is pulled forward with a Vicryl(®) (Ethicon) thread and clipped completely. From May 2010 to February 2011, 58 patients with PDA (27 boys and 31 girls) were operated on using the same technique. Patients' ages varied from 8 days to 36 months. Mean weight of patients was 5.9±2.8 kg (range, 2.1-10 kg). Mean operative time was 33±12 minutes (range, 15-90 minutes). There were no intraoperative complications. Postoperative complications occurred in 2 patients: 1 patient developed a pneumothorax, and 1 patient had pleural effusion. Mean postoperative stay was 4.1±2.1 days for patients >3 months old and 11.9±8.4 days for patients ≤3 months old. No injuries of recurrent laryngeal nerve occurred in any patients, and there were no residual shunts in any patients 3-6 months after discharge. A modified technique of thoracoscopic closure is a safe and effective procedure for PDA in children.