Clinical PaperThoracoscopic division of vascular rings

Background/PurposeVascular rings are traditionally treated via an open thoracotomy. In recent years the use of thoracoscopy has increased. Herein we report our experience with thoracoscopic division of vascular rings in pediatric patients.MethodsWe reviewed all patients who underwent thoracoscopic or open division of a vascular ring at our institution between 2007 and 2015. We analyzed patient demographics, presenting symptoms, diagnostic imaging modality, ring anatomy, operative details, complications, and symptom resolution.ResultsThirty-one patients underwent thoracoscopic division of a vascular ring while sixteen had open operations. Median age was 24 months in the thoracoscopic group and 13 months in the open group. Operative time averaged 74 min (thoracoscopic) and 95 min (open). There were no mortalities at 30 days. There was complete symptom resolution in 71% of thoracoscopic patients and 63% of open. Patients in the thoracoscopic group had decreased ICU admissions (10% vs. 94%), chest tube use (62% vs. 100%), chylothorax (6% vs. 38%) and overall length of stay (1.7 days vs. 5 days).ConclusionsThoracoscopic division of vascular rings in pediatric patients is a feasible alternative to open division and is associated with comparable rates of symptom resolution and decreased length of hospital stay and chylothorax.Level of evidenceIII.