[Assessment of Blalock-Taussig shunts in children with complex cardiac anomalies associated with reduced pulmonary blood flow and total anomalous pulmonary venous drainage].
Eleven patients with syndromes of asplenia and polysplenia associated with total anomalous pulmonary venous drainage (TAPVD) were underwent Blalock-Taussig (B-T) shunt operation for reduction of pulmonary blood flow. The age of patients at operation were 6 days to 5 years (average 19.5 +/- 18.7 month). There were seven patients in supracardiac type and four in cardiac type of TAPVD. All patients didn't present obstruction to pulmonary venous return (PVO) before B-T shunt operation. There were one early (9%) and two late deaths (20%) after surgery. Although the hospital death was related to perioperative errors. Two late deaths were not due to the PVO. One of infants had moderately pulmonary congestion and cardiac failure after shunt procedure. Two patients were measured pressure gradient (3 to 4 mmHg) between common pulmonary vein to atrium chamber before shunt procedure. Repeated catheterization revealed that 6 of them could be measured pressure gradient, 3 to 7 mmHg, and no patients had clinical sign of the PVO. Our results demonstrated that B-T shunt operation could be satisfactory for syndromes of asplenia and polysplenia associated with reduced pulmonary blood flow and TAPVD.
Watanabe
S
S
First Department of Surgery, Osaka University Medical School.
Matsuda
H
H
Nakano
S
S
Shimazaki
Y
Y
Miura
T
T
Kawashima
Y
Y
Sano
T
T
Kishimoto
H
H
D000714:Anastomosis, Surgical / Q000379:methods; D002675:Child, Preschool; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011651:Pulmonary Artery / Q000601:surgery*; D011652:Pulmonary Circulation; D011667:Pulmonary Veins / Q000002:abnormalities*; D013348:Subclavian Artery / Q000601:surgery*