{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T23:24:13Z","timestamp":1788305053701,"version":"build-2803163510"},"reference-count":16,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1999,8,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background.<\/jats:title>\n                    <jats:p>Video-assisted thoracoscopic surgery (VATS) has been assuming an expanded role in the management of cardiothoracic disease. As instrumentation and experience increase, VATS is being applied to treat smaller patients. We report our experience with 34 low birth weight infants undergoing VATS interruption of patent ductus arteriosus (PDA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods.<\/jats:title>\n                    <jats:p>VATS allows PDA interruption without the muscle cutting or rib spreading of a standard thoracotomy. Four small, 3-mm incisions are made along the line of a potential thoracotomy incision. Ports placed through these incisions admit endoscopic instruments, a camera, and a vascular clip applier.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results.<\/jats:title>\n                    <jats:p>Median age at surgery was 15.5 days (range: 1\u201344 days). Median weight at surgery was 930 g (range: 575-2500 g). Twenty patients weighed &amp;lt;1 kg, and 13 weighed &amp;lt;750 g. All patients had congestive heart failure and had either failed indomethacin therapy or had contraindications to indomethacin.<\/jats:p>\n                    <jats:p>Median surgical time was 60 minutes (range: 31\u2013171 minutes). Echocardiography documented elimination of ductal flow in all patients. Operative mortality was zero. Four patients (4\/34 = 12%) required conversion to open thoracotomy: 1 because of difficult exposure, 1 because of pulmonary dysfunction and anasarca, 1 because of a large 1-cm duct, and 1 because of coagulopathy and poor pulmonary compliance. Two patients died before discharge: 1 patient (surgical weight: 605 g) died on postoperative day 2 because of intracranial hemorrhage, and 1 patient (surgical weight: 1725 g) died on postoperative day 88 because of multiple system organ failure.<\/jats:p>\n                    <jats:p>Follow-up has demonstrated no PDA murmur in any patient, but echocardiography revealed trace ductal flow in 2 patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions.<\/jats:title>\n                    <jats:p>VATS offers a minimally traumatic, safe, and effective technique for PDA interruption in low birth weight neonates and infants.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1542\/peds.104.2.227","type":"journal-article","created":{"date-parts":[[2004,8,13]],"date-time":"2004-08-13T19:45:45Z","timestamp":1092426345000},"page":"227-230","source":"Crossref","is-referenced-by-count":74,"title":["Video-Assisted Thoracoscopic Surgery for Patent Ductus Arteriosus in Low Birth Weight Neonates and Infants"],"prefix":"10.1542","volume":"104","author":[{"given":"Redmond P.","family":"Burke","sequence":"first","affiliation":[{"name":"From the Division of Cardiovascular Surgery, Miami Children's Hospital, Miami, Florida;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey P.","family":"Jacobs","sequence":"additional","affiliation":[{"name":"Division of Thoracic and Cardiovascular Surgery, All Children's Hospital, University of South Florida College of Medicine, St Petersburg, Florida; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen","family":"Cheng","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Surgery, Cedars Sinai Hospital, Los Angeles, California."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfredo","family":"Trento","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Surgery, Cedars Sinai Hospital, Los Angeles, California."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory P.","family":"Fontana","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Surgery, Cedars Sinai Hospital, Los Angeles, California."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[1999,8,1]]},"reference":[{"key":"2021121002552233900_B1","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1001\/jama.1939.02800080049011","article-title":"Surgical ligation of a patent ductus arteriosus: report of first successful case.","volume":"112","author":"Gross","year":"1939","journal-title":"JAMA"},{"key":"2021121002552233900_B2","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1016\/S0022-5223(19)33812-7","article-title":"A new video-assisted thoracoscopic surgical technique for interruption of patent ductus arteriosus in infants and 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