A 15-YEAR EXPERIENCE WITH AN OLD BUT STILL CHALLENGING OPERATION: THE SYSTEMIC-PULMONARY ARTERY SHUNT

Abstract

Objective: The true incidence of congenital cardiovascular malformations is difficult to determine accurately, partly because of difficulties in definition. About 0.8 percent of live births are complicated by a cardiovascular malformation. Hypoxia and cyanosis, the common complications of all cyanotic disease, may be life-threatening in severe forms. Today, the trend is towards the total surgical correction of these anomalies in early life. As the accomplishment of this strategy in various parts of the world is not possible, palliative procedures like systemic-pulmonary shunt have retained their importance.<br />Methods: Data were collected from the files of 180 patients, for whom systemic-pulmonary shunt was performed by a single surgical group at our center between March 1992 and May 2006. Our aim was to determine the outcome of shunt operation in terms of success rate, morbidity, and mortality.<br />Results: The median age and weight of the patients was 24 months and 10.5 kilograms, respectively. There was a spectrum of underlying cyanotic heart diseases. The main operation was the modified Blalock-Taussig shunt (90%). The mean value of oxygen saturation was 62% pre-operatively, which rose to 85% after surgery. We found a 77.9% success rate, 6.7% mortality rate, and 8.7% morbidity rate.<br />Conclusion: There was no significant correlation between the predictive factors and success of operation. Lower age and weight of the patient, small size of the pulmonary artery, and urgency of operation predicted the operative mortality.