Systemic-pulmonary polytetrafluoroethylene shunts in palliative operations for congenital heart disease

Amato, Joseph J.; Marbey, Mark L.; Bush, Cathy; Galdieri, R; Cotroneo, Joseph V.; Bushong, Joanne

doi:10.1016/s0022-5223(19)35387-5

Cited by 43 publications

(20 citation statements)

References 12 publications

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“…Significant relationships between outcomes and diagnostic group, shunt type, and surgical approach were not found in our study. 2,4,5,12,17,[21][22][23][24][25] Previous reports have demonstrated inconsistent findings regarding these issues. Factors that may in part account for our findings include the weight restriction of the cohort and the exclusion of patients undergoing other major concomitant procedures.…”

Section: Discussionmentioning

confidence: 99%

“…Our discharge survival of 96% compares favorably with the range of 85%-94% reported by others for cohorts not restricted to small patients. [4][5][6][11][12][13][14][15][16][17][18] Recently, Petrucci and colleagues 5 reported on a multiinstitutional series from the STS Congenital Heart Surgery Database of more than 1200 patients; 592 patients weighed between 1.5 and 3.0 kg at the time of SPS. Discharge survival was 84.4% in patients weighing 2-2.5 kg and 89% in all patients weighing less than 3 kg.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Outcomes of systemic to pulmonary artery shunts in patients weighing less than 3 kg: Analysis of shunt type, size, and surgical approach

Myers

Ghanayem

Cao

et al. 2014

The Journal of Thoracic and Cardiovascular Surgery

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Outcomes of systemic to pulmonary artery shunts in patients weighing less than 3 kg: Analysis of shunt type, size, and surgical approach

Myers

Ghanayem

Cao

et al. 2014

The Journal of Thoracic and Cardiovascular Surgery

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“…In our study, 41 patients received the second corrective operation and no pulmonary artery distortion was found. Kandakure et al and Amato et al showed that the shunt through a median sternotomy approach would not likely distort the pulmonary artery compared with the thoracotomy approach.…”

Section: Discussionmentioning

confidence: 99%

Central Shunt Procedures for Complex Congenital Heart Diseases

Bao

Pan

et al. 2014

J Card Surg

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“…Many authors have reported the advantages of the sternotomy approach for MBT shunt; it provides good exposure of the vessels, easy control of patent ductus arteriosus, initiation of cardiopulmonary bypass if necessary, and easy takedown of the shunt and reconstruction of the pulmonary artery during later procedures. Moreover, it avoids lung compression, respiratory compromise, late scoliosis, and a second chest scar [1,3,10,11].…”

Section: Discussionmentioning

confidence: 99%

Ministernotomy approach for modified Blalock-Taussig shunts in neonates: a feasibility study

Midany

Doghish

2019

Cardiothorac Surg

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Background: The original approach to performing a modified Blalock-Taussig (MBT) shunt is via a left thoracotomy. However, the median sternotomy has become the preferred approach of many surgeons. We think that the upper ministernotomy approach provides several advantages and avoids the disadvantages of both the sternotomy and thoracotomy approaches. Here, we describe our experience in constructing neonatal MBT shunts via upper ministernotomy. Methods: A prospective study was conducted on 50 neonates who underwent modified Blalock-Taussig shunt performed through upper ministernotomy between March 2011 and December 2016. Preoperative characteristics, mortality, and morbidity were recorded. Results: Mean age was 16.9 ± 10.4 days, and weight was 3.5 ± 0.5 kg. All patients received grafts of size 3.5 mm. The mean oxygen saturation increased from 59.5 ± 7.3% preoperatively to 84.8 ± 4.2% postoperatively. There were three cases of mortality (6%). One patient suffered from an unstable sternum (2%). No patients required conversion to full sternotomy. Superficial wound infection occurred in three cases (6%), and there were no cases of mediastinitis. Mean duration of ventilation was 55.64 ± 37.5 h, mean ICU stay was 5.44 ± 3.9 days, and mean hospital stay was 14.7 ± 7.2 days. Conclusion: Upper ministernotomy is a safe approach with good early results. It provides adequate exposure with limited surgical trauma. Emergency conversion to full sternotomy and initiation of cardiopulmonary bypass can be achieved easily. It avoids lung compression and respiratory compromise. Additional costs for specific instruments are not necessary.

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Systemic-pulmonary polytetrafluoroethylene shunts in palliative operations for congenital heart disease

Cited by 43 publications

References 12 publications

Outcomes of systemic to pulmonary artery shunts in patients weighing less than 3 kg: Analysis of shunt type, size, and surgical approach

Outcomes of systemic to pulmonary artery shunts in patients weighing less than 3 kg: Analysis of shunt type, size, and surgical approach

Central Shunt Procedures for Complex Congenital Heart Diseases

Ministernotomy approach for modified Blalock-Taussig shunts in neonates: a feasibility study

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