title: Central shunt procedures for complex congenital heart diseases.
abstract: OBJECTIVE
  The study was designed to analyze the results of central shunt procedure using Gore-Tex grafts for treatment of patients with complex congenital heart diseases.
  
  
  METHODS
  A Gore-Tex graft was implanted using an end-to-side anastomosis technique connecting the aorta with the pulmonary artery. The graft size was determined based on the patients' body weight. Artery growth and percutaneous plasma oxygen were examined pre- and postoperatively.
  
  
  RESULTS
  The procedure was performed without cardiopulmonary bypass in 96 of 110 cases. Shunt sizes from 3.5 to 6.0 mm were employed. After operation, the oxygen saturations increased significantly from 65.2% ± 7.3 to 84.1% ± 3.8 (p < 0.05). Both left and right pulmonary arteries were found to grow significantly in size, from 4.9 ± 1.8 to 7.5 ± 2.0 mm and from 6.1 ± 2.3 to 8.0 ± 4.7 mm, respectively (p < 0.05). Early mortality was 5.5% (6/110). Major shunt-related complications included congestive heart failure (1.8%, 2/110) and acute shunt occlusion (1.8%, 2/110). Median follow-up was 18 months (range 6 to 61), with late mortality of 3.8% (4/104) one month postoperation.
  
  
  CONCLUSIONS
  The central shunt increases oxygen saturation and improves pulmonary artery development effectively with a relatively low incidence of congestive heart failure, acute occlusion, and pulmonary distortion. The adequate postoperation survival, low morbidity and mortality, and less technical difficulty of this procedure make it a more desirable treatment for complex heart diseases.
authors.affiliation: Medical Center of Tsinghua University, Beijing, China; Department of Pediatric Cardiology, First Hospital of Tsinghua University, Beijing, China.
authors.forename: Min
authors.initials: M
authors.lastname: Bao
authors.forename: Hongyin
authors.initials: H
authors.lastname: Li
authors.forename: Guangyu
authors.initials: G
authors.lastname: Pan
authors.forename: Zhonghua
authors.initials: Z
authors.lastname: Xu
authors.forename: Qingyu
authors.initials: Q
authors.lastname: Wu
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods* / Q000401:mortality; D001011:Aorta / Q000601:surgery; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods* / Q000401:mortality; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000401:mortality / Q000601:surgery*; D006333:Heart Failure / Q000517:prevention & control; D006801:Humans; D007223:Infant; D008297:Male; D010100:Oxygen / Q000097:blood; D011138:Polytetrafluoroethylene; D011183:Postoperative Complications / Q000517:prevention & control; D011474:Prosthesis Design; D011651:Pulmonary Artery / Q000601:surgery; D013534:Survival; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D011138:Polytetrafluoroethylene; D010100:Oxygen