Abstract
The right pulmonary artery-aortic shunt often results in undesirable sequelae related to unequal flow to both lungs. Subsequent repair of the anastomosis may also be difficult. Expanded microporous polytetra-fluoroethylene (PTFE) is useful for constructing conduits for small-vessel bypass. In past 18 months, 11 babies, age 1 to 18 days (8), weight 2.1 to 3.6 Kg (2.9), underwent PTFE aorto-pulmonary shunt. All were critically-ill, cyanotic and with complex cardiac anomalies including pulmonary atresia (6) or severe pulmonary stenosis (5). A 4 mm-diameter PTFE conduit, 2 to 6 cm (4) long, was anastomosed to ascending aorta and pulmonary trunk or its bifurcation. Preshunt arterial O2 saturation was 72% (range, 33-80), and postshunt saturation 87% (range, 78-90). One baby with asplenia died from ventricular fibrillation during surgery; 3 others died from non-surgical causes (CVA, pseudomonas sepsis, inadequate atrial defect). The 7 long-tern survivors (2-17 months follow-up, mean=12) are clinically well. Hemodynamic studies in 2 showed comparable flows to both lungs. Clinical observations and animal flow studies have demonstrated optimal length of the 4 mm-diameter PTFE as 2.5 to 4 cm. The PTFE shunt is effective for palliation in newborn cables.
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Lamberti, J., Lin, C., Reploqle, R. et al. PROSTHETIC (TEFLON) AORTO-PULMONARY SHUNT FOR CYANOTIC NEWBORN BABIES. Pediatr Res 11, 394 (1977). https://doi.org/10.1203/00006450-197704000-00151
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DOI: https://doi.org/10.1203/00006450-197704000-00151