Minimally Invasive Surgical Options for Treating Pediatric Patent Ductus Arteriosus

There are two primary surgical approaches for treating pediatric patent ductus arteriosus (PDA), with minimally invasive techniques becoming the preferred method in modern practice. One widely used option is catheter-based intervention, which involves accessing the ductus through a blood vessel, typically via a small puncture made in the femoral artery or vein. A closure device is then guided through the catheter to seal the PDA, offering a less invasive alternative with minimal scarring.

Benefits of Catheter-Based Closure

This procedure is associated with a very small incision, usually only 2–5 mm in size, resulting in faster recovery times and reduced risk of infection or complications compared to open-chest surgeries. It is typically performed under general anesthesia and often allows patients to return home within 24 to 48 hours post-procedure.

Potential Risks and Considerations

One notable drawback of this technique is the use of fluoroscopic imaging during the procedure, which exposes both the patient and medical team to low levels of radiation. While the exposure is generally considered safe, it remains a concern for some families and medical professionals. Additionally, there is a small risk of device displacement, vascular injury, or incomplete closure, though these complications are rare.

Alternative Minimally Invasive Approaches

In select cases where catheter-based closure is not feasible—such as in patients with anatomical abnormalities or unusually large PDAs—surgeons may opt for a thoracoscopic approach. This involves making small incisions between the ribs and using specialized instruments to either ligate or clamp the ductus arteriosus under video guidance. While effective, this method is less commonly used due to the high success rates and lower complication profile of transcatheter closure.

Conclusion

Minimally invasive techniques, particularly catheter-guided closure, have revolutionized the treatment of pediatric patent ductus arteriosus. These approaches offer significant advantages over traditional open surgery, including shorter hospital stays, reduced pain, and excellent long-term outcomes. As technology and interventional cardiology continue to advance, the safety and efficacy of these procedures are expected to improve even further.