Abstract | BACKGROUND: Excessive pulmonary blood flow increases ventricular volume work in the face of inadequate systemic cardiac output, low diastolic blood pressure, and inadequate coronary perfusion. Using the smallest available 3-mm polytetrafluoroethylene shunts have been successful, although catastrophic shunt thrombosis has occasionally been observed. To avoid thrombosis with a smaller conduit, saphenous vein homografts (SVG) were used to construct the modified Blalock-Taussig (BT) shunts. METHODS: From January 1998 to April 1999, 25 patients weighing 3.1 kg (3.0 kg or less, n = 9), at a mean age of 8.9 days, underwent stage I Norwood using an SVG BT shunt. Common heart defects were aortic atresia (n = 8), mitral atresia and double-outlet right ventricle (n = 5), and unbalanced AVC (n = 5). Mean BT shunt size was 3.2 mm, with 12 patients having shunts that were 3 mm or smaller. RESULTS: Thirty-day hospital mortality was 8% (2 of 25). No shunt thrombosis was seen, despite banding the BT shunt in 3 patients. One patient had BT revision because of an anatomic issue not directly related to the shunt material. CONCLUSIONS: Excellent results may be achieved using SVG BT shunts in the Norwood operation. This conduit seems less likely to thrombose, both acutely and chronically, allowing the use of appropriately smaller-sized shunts in small neonates.
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Authors | V K Tam, K Murphy, W J Parks, A A Raviele, R N Vincent, M Strieper, A R Cuadrado |
Journal | The Annals of thoracic surgery
(Ann Thorac Surg)
Vol. 71
Issue 5
Pg. 1537-40
(May 2001)
ISSN: 0003-4975 [Print] Netherlands |
PMID | 11383796
(Publication Type: Journal Article)
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Topics |
- Angiography
- Female
- Heart Defects, Congenital
(mortality, surgery)
- Hospital Mortality
- Humans
- Hypoplastic Left Heart Syndrome
(mortality, surgery)
- Infant, Newborn
- Male
- Palliative Care
- Postoperative Complications
(diagnostic imaging, mortality, surgery)
- Reoperation
- Survival Rate
- Transplantation, Homologous
- Veins
(pathology, transplantation)
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