Angiographic demonstration of complications resulting from the Waterston procedure

Catheterization Treatment of Stenosis and Hypoplasia of Pulmonary Arteries

“…Shunt surgery may have been performed on patients in order to increase pulmonary blood flow; scarring in the area of insertion of these shunts may lead to significant residual stenosis. These problems have been documented following Waterston shunts [1,17,21,27,52,58] and Potts shunts [55]. Strictures secondary to either type of anastomosis have led to isolation of the ispilateral branch pulmonary artery or to difficulty during subsequent reparative surgery.…”

Intervening for RPA stenosis following Waterston shunt: Importance of anatomical definition of the coronary arteries

“…In those patients who underwent later total intracardiac repair and closure of the anastomosis, they also described RPA stenosis in 9/14 (64%). Similarly, in a retrospective study by Levin et al , 63% demonstrated significant narrowing or total obstruction at the site of anastomosis.…”

Echocardiogram‐gated multislice spiral CT in functionally univentricular heart following long‐lasting Waterston–Cooley anastomosis

“…It is associated with early and late complications in a significant number of cases. These complications include preferential distribution of shunt flow to the right lung, thrombosis, embolism, kinking, narrowing or obstruction of the right pulmonary artery at the anastomotic site, increasing stenosis or atresia of the right ventricular outflow tract, hypoplasia of the left pulmonary artery and obstruction of the shunt itself 10,11 . Rupture of pulmonary aneurysms and dissecting haematomas of the pulmonary artery in association with long‐standing Waterston shunts have been described as well 12,13 …”