Thoracoscopic Clipping of Patent Ductus Arteriosus

Abstract

Figure 1. A continuous murmur heard on the 10th day of life in a 590-g infant delivered at 25 weeks' gestation led to the diagnosis of patent ductus arteriosus. The child had numerous medical problems, including hyaline membrane disease, renal dysfunction, sepsis, and intraventricular hemorrhages. High inspired-oxygen concentrations, high airway pressures, and inotropic support were required. A video-assisted thoracoscopic approach was used because the ductus did not close after treatment with indomethacin and the child was too small for a transcatheter procedure. A 4-mm video camera was placed in the left pleural space through a small stab wound (Panel A). . . .