Álvarez-Tostado RA, Millán MA, Álvarez-Tostado RE

Language: Spanish
References: 4
Page: 188-190
PDF size: 37.87 Kb.

ABSTRACT

The need of a postop chest tube after a PDA thoracoscopic occlusion is in doubt, it’s absence should simplify the postop care. A report of PDA thoracoscopic occlusion results by clipping and ligation is made in 62 cases, 31 with chest tube and 31 without chest tube, 42 female and 20 male, age range between prematures and 15 years. The surgical indication was primary correction of a non complicated PDA or as the first step in the management of a more complex congenital cardiopathy. The occlusion is performed by a previously described technic, inserting a 14 French Nelaton tube through one of the surgical ports, withdrawing it when the last stich is tied, when no chest tube is left or leaving a 20 French chest tube through one of the surgical ports, secured by a skin stich. The surgical time range was 30 to 120 minutes. Three cases were converted, 2 for bleeding and 1 for a PDA plus an aortic coarctation. In one case no patent duct was found. No one of the 31 cases without tube needed it. There has not been recurrent nerve lesion. There has been a hundred percent duct occlusion, with no recurrence until now. The patients without a chest tube are ready for discharge in 24 or 48 hours. The use or not of a chest tube must be individualized. If these results are reproducible by other groups, it should be the treatment of choice.

REFERENCES

1. Gross RE. Complete surgical division of the patent ductus arteriosus: a report of fourteen successful cases. Surg Gynecol Obstet 1944; 78: 36-43.

2. Álvarez-Tostado RA, Millán MA, Tovar LA, Shuchleib S, Álvarez-Tostado RE, Chousleb A. Thoracoscopic clipping and ligation of a patent ductus arteriosus. Ann Thorac Surg 1994; 57: 755-7.

3. Álvarez-Tostado RA. Disección de ventana aortopulmonar, ventana pericárdica y ligadura de conducto arterioso. Rev Inst Enf Resp Mex 1995; 8: 70-71.

4. Álvarez-Tostado RA, Álvarez-Tostado RE. 56 Cirugía Toracoscópica Videoasistida en el tratamiento del Conducto Arterioso. Cirugía Laparoscópica, McGraw-Hill-Interamericana, 2ª Ed. México 1997.