The modern approach to patent ductus arteriosus treatment: complementary roles of video-assisted thoracoscopic surgery and interventional cardiology coil occlusion
| Autor: | Luis M. Botero, Jorge M. Giroud, James A. Quintessenza, Jeffrey P. Jacobs, Hugh M. van Gelder, Victor O. Morell, Vinay Badhwar, Redmond P. Burke |
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| Rok vydání: | 2003 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine Cardiac Catheterization medicine.medical_specialty Adolescent medicine.medical_treatment education Risk Assessment Sensitivity and Specificity Cohort Studies Postoperative Complications Ductus arteriosus Occlusion Coil occlusion Humans Medicine Thoracotomy Child Ductus Arteriosus Patent Retrospective Studies Interventional cardiology Thoracic Surgery Video-Assisted business.industry Patient Selection Infant Newborn Infant nutritional and metabolic diseases Balloon Occlusion Echocardiography Doppler Surgery Survival Rate Treatment Outcome medicine.anatomical_structure Treatment modality Child Preschool Video-assisted thoracoscopic surgery Female Cardiology and Cardiovascular Medicine business Hospital stay Follow-Up Studies |
| Zdroj: | The Annals of Thoracic Surgery. 76:1421-1428 |
| ISSN: | 0003-4975 |
| DOI: | 10.1016/s0003-4975(03)01035-x |
| Popis: | Background In an effort to analyze our experience and develop treatment guidelines, we reviewed all our patients with patent ductus arteriosus (PDA) treated with video-assisted thoracoscopic surgery (VATS) or interventional cardiology coil occlusion. Methods One hundred patients underwent 102 cardiac catheterizations. Forty-five children underwent VATS. The entire cohort of patients is 141 because 4 patients underwent both catheterization and VATS. Results Successful PDA coil occlusion occurred in 91 patients (91 of 100; 91%); 8 had unsuccessful attempts at coil occlusion and 1 was referred for surgical ligation after catheterization without any attempt at coil placement. Thirty-nine children had successful VATS PDA closure. Six children required conversion to thoracotomy because of inadequate exposure during VATS. Hospital stay for children more than 45 days of age was as follows: VATS median stay, 1 day, mean, 1.4 days; thoracotomy median stay, 4 days, mean, 4.6 days. One patient treated with PDA coil occlusion developed a recurrent PDA and required reembolization. Three children underwent initial catheterization without successful coil placement with subsequent successful VATS. All VATS patients left the operating theater with echocardiography documenting no residual PDA. Two children who underwent successful VATS with no residual PDA at hospital discharge were found on outpatient follow-up to have developed tiny recurrent PDAs and both were successfully coil occluded; 1 of these 2 children is 1 of the 3 children initially evaluated by catheterization and then referred for VATS. Conclusions Video-assisted thoracoscopic surgery and coil occlusion represent complementary techniques for PDA treatment. A rationale for selection of the appropriate treatment modality can be based upon the size and age of the patient and the size and morphology of the PDA. |
| Databáze: | OpenAIRE |
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