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Persistent RAA and PDA
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Thoracoscopy is being more and more frequently used in veterinary surgery to treat several conditions. Thoracoscopy has been used to transect the ligamentum arteriosum during the persistence of the 4th right aortic arch or ligate a patent ductus arteriosus.
Approach
To perform minimally invasive PRAA correction the patient is placed in right lateral recumbency. Three or four portals are required. Three portals are placed in the 7 or 8th intercostal space and the fourth cannula is placed in the one intercostal cranial in the ventral third of the space. A retractor or a palpation probe used as a retractor is introduced in that portal. If only three portals are used one lug ventilation greatly facilitates the surgery because the left cranial lung lobe is not interfering with visualization.
Equipment used
Five millimeters equipment can be used for the procedure. However, since most of the dogs are very young and less than 8 kg a pediatric set of equipment is more appropriate. Pediatric equipment is usually 2.7 mm in diameter. Five millimeter diameter cannulas are difficult to place in the intercostal space. One 5 mm cannula will still be need for introduction of vascular clip or vessel sealant device.
A 5 Fr endobronchial blocker is used to induce one ventilation. A bronchoscope is used to visualize the accurate placement of the blocker in the left main stem bronchi. The cuff is inflated enough to obstruct the bronchi. [...]
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