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ABSTRACT 93 POSTOPERATIVE PAIN AND QUALITY OF LIFE IN PATIENTS UNDERGOING ATRIAL SEPTAL DEFECT REPAIR USING MINIMALLY INVASIVE AND ROBOTIC TECHNIQUES Jeffrey A. Morgan, MD, Karen W. Hollingsworth, BS, Nicholas J. Colletti, BS, Takushi Kohmoto, MD, Mauricio J. Garrido, MD, Aftab R. Kherani, MD, Deon W. Vigilance, MD, Faisal H. Cheema, MD, Eric A. Rose, MD, Craig R. Smith, MD, Mehmet C. Oz, MD, Michael Argenziano, MD Division of Cardiothoracic Surgery, College of Physicians and Surgeons, Columbia University, New York, New York, USA BACKGROUND: Although most studies of minimally invasive cardiac surgery have reported morbidity and mortality, few have addressed more subjective outcome measures, such as pain and quality of life QOL ; . METHODS: Over a 15 month period, 17 patients underwent atrial septal defect ASD ; repair by a totally endoscopic robotic TE-R ; approach. These patients were compared to a similar number of patients who underwent repair of their ASD by a mini-thoracotomy MT ; or sternotomy. QOL was assessed on postoperative day 30 by administering the Medical Outcomes Study Short Form Survey SF-36 ; . QOL endpoints included bodily pain, vitality, mental health, general health, physical function, and social function. RESULTS: At 30 days, QOL was best for TE-R patients in all 8 categories, most pronounced in bodily pain BP, p 0.014 ; , mental health MH, p 0.034 ; , and vitality VT, p 0.036 ; table ; . Patients undergoing minithoracotomy, however, did not fare better than those undergoing sternotomy. CONCLUSION: Repair of an ASD can be performed safely and effectively via a totally endoscopic approach. The totally endoscopic robotic approach resulted in the least postoperative pain and best quality of life despite increased cross clamp and bypass times. Day 30 BP Day 30 MH Day 30 VT BP time min ; XCl time min ; Sternotomy 42 25 68 TE-R 83 25 93 ABSTRACT 95 CLOSURE OF PATENT DUCTUS ARTERIOSUS BY VIDEO-ASSISTED THORACOSCOPIC SURGERY; MINIMALLY INVASIVE, MAXIMALLY EFFECTIVE: REPORT OF 550 CASES Mohammad Hassan NEZAFATI , Ali HAMEDANCHI Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran OBJECTIVE: In the last decade, increasing interest has focused on diferent applications and various aspects of minimally invasive surgery. To further determine the safty and efficasy of video-assisted thoracoscopic surgical VATS ; closure of Patent Ductus Arteriosus PDA ; , we prospectively studied 550 patients treated by this new method. METHODS: From June 1997 to October 2002, 550 consecutive patients diagnosed as PDA mean age: 6 years old ; , were referred to us, all of them met our inclusion criteria eligible for VATS procedure. Recently, we have made some minor alterations in our routine metodology, which will be discussed in more detail later. After complete closure of PDA by two titanium clips the extubated patient leaves the Operating Room without a chest tube. RESULTS: All the pertaining data were collected and analyzed. There were two cases of chylothorax, which were succesfully treated by thoracotomy and ligation of the small lymphatic ducts, after one week of close observation. The procedure was changed to thoracotomy in four adult patients due to inappropriately dilated canal grater than 9 mm ; , meanwhile, four aditional paients developed transient recurrent laryngeal nerve dysfunction. All cases were re-assessed immediately after the procedure, and followed for more than 5 years by conrtol echocardiography. No significant complication and residual shunt was recorded during the follow-up period. Mean procedure time was about 15 2 minutes. All patients were discharged shortly after the procedure ~20 hours ; . CONCLUSIONS: This experience indicate that video-assisted thoracoscopic surgery is superior to other techniques of ductal closure, as well as it is simple, rapid, cost-effective, and more comfortable for the patients, in addition to the cosmetic benefits and macrobid. Lotensin relaxes arteries that will lower blood pressure, but also help improve the pumping of a failing heart and improve cardiac output with those with heart failure. Petroleum and Products--Con. Petroleum refining industry--Con. 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