Purpose: Video-assisted endoscopic techniques have recently been employed in congenital heart surgery for patent ductus arteriosus (PDA) interruption. We report our preliminary experience of using a new technique of single-lung ventilation to perform video-assisted thoracoscopic PDA interruption (VATS-PDA) in small infants and children.
Methods: Sixteen infants with a mean body weight of 6.5 +/- 2.4 kg (range 2.6-12.8 kg) underwent VATS-PDA under selective right-lung ventilation using a 2-F balloon catheter for arterial embolectomy.
Results: We did not need to reposition the retractor or reinflate the atelectatic lung, as there was no transient hypoxia or hypercarbia. The mean procedure time was 81 +/- 27 min (range 45-145 min) and all patients, with the exception of one with a total anomalous pulmonary venous connection, were extubated in the operating room.
Conclusion: This technique using single-lung ventilation for infants and small children was safe and effective in providing pediatric thoracic access and exposure within confined and delicate anatomic spaces.