Progress of patients with pulmonary atresia after systemic to pulmonary arterial shunts
| Autor: | Alan R. Kerr, John M. Neutze, Patricia M. Clarkson, A.Louise Calder, Nien-Shen Chan |
|---|---|
| Rok vydání: | 1991 |
| Předmět: |
Heart Defects
Congenital Reoperation Pulmonary and Respiratory Medicine congenital hereditary and neonatal diseases and abnormalities medicine.medical_specialty Palliative care Subclavian Artery Arterial Occlusive Diseases Pulmonary Artery Blood vessel prosthesis medicine.artery Humans Medicine Abnormalities Multiple Polytetrafluoroethylene Vascular Patency Pulmonary Valve Univariate analysis business.industry Anastomosis Surgical Angiocardiography Palliative Care Infant Newborn Infant Prognosis medicine.disease Blood Vessel Prosthesis Surgery Survival Rate Stenosis medicine.anatomical_structure Pulmonary valve Atresia Pulmonary artery Cineangiography Cardiology and Cardiovascular Medicine business Pulmonary atresia |
| Zdroj: | The Annals of Thoracic Surgery. 51:401-407 |
| ISSN: | 0003-4975 |
| Popis: | Between February 1980 and June 1987, 42 shunts were placed in 39 infants with pulmonary atresia: 33 were modified Blalock-Taussig shunts with polytetrafluoroethylene (PTFE) and 9 were classic Blalock-Taussig shunts. There were four hospital deaths not related to the shunts. The remaining 35 patients were followed up for 1.6 months to 6.3 years (mean, 24.7 +/- 18 months). Repeat cineangiocardiographic studies revealed stenosis or distortion of the pulmonary arteries related to the site of the shunt in 11/22 patients (50%) with PTFE shunts and in 1/6 (17%) with classic Blalock-Taussig shunts; the stenosis was severe in only 1 patient. Mean increase in the pulmonary arterial index in the group with classic Blalock-Taussig shunts was 117 +/- 52 mm2/m2 (not significant) and in the group with PTFE shunts, 158 +/- 21 mm2/m2 (p less than 0.001). Late shunt occlusion occurred in 1 patient 23 months postoperatively. Thereafter, shunt patency rate remained at 94% +/- 6%. At the end of 1 year 81% +/- 7% of patients were judged to have adequate palliation, but between 2 and 3 years, only 60% +/- 10%. Univariate analysis showed that after 2 years the ranking order for successful palliation was classic Blalock-Taussig, 5-mm PTFE, and 4-mm PTFE shunts, but differences did not achieve statistical significance. |
| Databáze: | OpenAIRE |
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