Outcome of Systemic-to-Pulmonary Shunts in Cyanotic Congenital Heart Disease-A 9-year Experience

Department of cardiovascular Surgery, Shahid Madani Heart Center, Tabriz University of Medical Sciences, Tabriz, Iran

ABSTRACT The aim of this study is to evaluate early and late results of surgery in children with congenital heart disease and decreased pulmonary blood flow, who underwent a palliative systemic-to-pulmonary shunt. During the past 9 years, 157 systemic-to-pulmonary artery shunts were performed in 130 patients (69 males, 61 females) with ages from 1 day to 31 years old. They had been evaluated for their clinical effectiveness, the need for a repeat operation and the mortality and morbidity. There were 101 (77.7%) modified Blalock-Tausig (BT) shunts, 19 (14.6%) modified Waterston shunts, 8 (6.2%) Central shunts, 1 Waterston shunt, and 1 Glenn shunt created throughout the study. Tetralogy of Fallot comprised the majority of cases (113; 86.9%) while the remaining 17 (13.1%) included transposition of the great arteries with pulmonary stenosis, tricuspid atresia, pulmonary atresia, atrioventricular septal defect (canal) with pulmonary stenosis, and univentricular heart complex. Early mortality was 12.3% (16 patients). Second shunts were created in 25 (19.2%) patients. Forty patients (30.8%) have undergone subsequent intracardiac repair 37.7 ± 17.8 months after original shunt procedure. There were four (3%) late deaths. Follow-up was achieved in 105 of 114 early survivors for a pe-riod of 3 to 117 months (mean 31.7 ± 19.4 months). Modified BT shunt was performed most frequently in our service; it was associated with less closure and mortality than other types of shunt and had excellent clinical palliation and patency rates.

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Available from: Farzad Kakaei, Aug 25, 2015
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