Maehara T, Ohgami M, Kokaji K, Yamashita Y, Wakabayashi G, Nohga K
Department of Cardiovascular Surgery, Kawasaki City Hospital, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1993 Sep;41(9):1522-7.
A five-year-old girl with patent ductus arteriosus (PDA) was successfully treated by thoracoscopic surgery, which was the first successful case in Japan. The operation was carried out under general anesthesia with usual endotracheal intubation. Short trocars were inserted through the left intercostal spaces to introduce a flexible video thoracoscope and adequate surgical instruments. After the ductus was carefully dissected and exposed, two titanium clips which were 11 mm in length were applied to interrupt the ductus completely. The continuous heart murmur of PDA was confirmed to disappear by an esophageal stethoscope. Postoperative course was uneventful and the patient was discharged on 6 postoperative day. No residual PDA shunt was revealed by doppler echocardiogram 8 months after surgery. The advantages of thoracoscopic surgery for PDA are: less postoperative pain and discomfort, early recovery and short hospital stay, and cosmetic preservation. Availability of smaller sized surgical instruments should allow this method indicated for smaller children or newborns with PDA.
一名患有动脉导管未闭（PDA）的五岁女孩通过胸腔镜手术成功治愈，这是日本首例成功病例。手术在全身麻醉和常规气管插管下进行。通过左肋间间隙插入短套管针，以引入可弯曲的电视胸腔镜和合适的手术器械。在仔细解剖并暴露动脉导管后，应用两个长度为11毫米的钛夹将动脉导管完全夹闭。经食管听诊器确认，PDA持续的心脏杂音消失。术后过程平稳，患者于术后第6天出院。术后8个月的多普勒超声心动图显示无动脉导管未闭残余分流。胸腔镜手术治疗PDA的优点包括：术后疼痛和不适较轻、恢复快、住院时间短以及美观。尺寸更小的手术器械的可用性应使这种方法适用于患有PDA的更小儿童或新生儿。
