Central aorta-pulmonary artery shunts in neonates with complex cyanotic congenital heart disease

Central Shunt Procedures for Complex Congenital Heart Diseases

“…Of the early shunt‐related complications, congestive heart failure associated with excessive pulmonary flow was another reason for not performing the central‐type shunt procedure . In our study, two patients experienced congestive heart failure, most likely due to larger graft size.…”

“…Gore & Associates, Flagstaff, AZ, USA), described by de Leval et al in 1981, has become the procedure of choice as a conduit to provide more predictable outcomes. In spite of great technical advances, the central‐type aorta‐pulmonary shunt may still suffer a high incidence of shunt failure and congestive heart failure . In this report, we analyze the outcomes of 110 patients with complex congenital heart disease who were treated with a central Gore‐Tex shunt, connecting the ascending aorta with the main pulmonary artery or the proximal right or left pulmonary artery, with the graft size being determined based on the patients' body weight.…”

Criterions for selection of patients for, and results of, a new technique for construction of the modified Blalock-Taussig shunt

“…Despite advances in the surgical correction of complex cyanotic diseases in infants and children, construction of systemic-to-pulmonary shunts still remains necessary, mostly as the first stage of repair. [1][2][3][4][5][6] Pulmonary arterial distortion, and complications in the use of native vessels to increase the flow of blood to the lungs, led to the more frequent use of polytetrafluoroethylene shunts, either in a central position, or as a modification of the classical Blalock-Taussig shunt. [6][7][8][9] The published literature shows that central aortopulmonary shunts have limited value because of the unacceptably high incidence of complications, such as thrombosis, congestive heart failure, and pulmonary arterial distortion.…”

“…[1][2][3][4][5][6] Pulmonary arterial distortion, and complications in the use of native vessels to increase the flow of blood to the lungs, led to the more frequent use of polytetrafluoroethylene shunts, either in a central position, or as a modification of the classical Blalock-Taussig shunt. [6][7][8][9] The published literature shows that central aortopulmonary shunts have limited value because of the unacceptably high incidence of complications, such as thrombosis, congestive heart failure, and pulmonary arterial distortion. [6][7][8] As yet, there is no fool-proof formula for choosing an optimal surgical approach, nor a given diameter for the shunt in any individual patient.…”

“…[6][7][8][9] The published literature shows that central aortopulmonary shunts have limited value because of the unacceptably high incidence of complications, such as thrombosis, congestive heart failure, and pulmonary arterial distortion. [6][7][8] As yet, there is no fool-proof formula for choosing an optimal surgical approach, nor a given diameter for the shunt in any individual patient. The issue as to whether the patent arterial duct should be ligated in the setting of a duct-dependent circulation also remains controversial.…”