Outcomes of thoracoscopic clipping versus transcatheter occlusion of patent ductus arteriosus: randomized clinical trial.

Aim: To compare outcomes of thoracoscopic clipping (TC) versus transcatheter occlusion (TO) for patent ductus arteriosus (PDA).

Patients And Methods: One hundred patients were enrolled in the study from May 2010 to December 2011. Those patients were randomized into 2 groups: group one received TC, group two received TO.

Result: There were no significant differences concerning width or length of the ductus (P>0.05). However the median age and median weight of patients in the TO group were greater than in the TC group (P<0.05). Mean operative time was 32 ± 12 min in the TC group versus 20 ± 3 min in the TO group (P<0.05). There were no deaths in either group. There were no complications in the TC group whereas three patients in the TO group had complications and required subsequent operation. Median postoperative stay was 3.5 days (IQR: 3.0-4.3) in the TC group versus 3 days (IQR: 2.0-4.0) in the TO group (P<0.05). There was no residual shunting in either group. Average cost for one patient was $645 ± 232 in the TC group versus $1,260 ± 204 in the TO group (P<0.001).

Conclusion: Thoracoscopic clipping is safer than transcatheter occlusion for PDA repair, with the same effectiveness and lower cost.