The Annals of Thoracic Surgery, Vol 28, 568-577, Copyright © 1979 by The Society of Thoracic Surgeons
The prosthetic (Teflon) central aortopulmonary shunt for cyanotic infants less than three weeks old: results and long-term follow-up
JJ Lamberti, C Campbell, RL Replogle, C Anagnostopoulos, CY Lin, P Chiemmongkoltip and R Arcilla
The expanded microporous polytetrafluoroethylene (PTFE) 4 mm vascular
prosthesis has been used to create a central aortopulmonary shunt in 20
critically ill infants less than 3 weeks old. The infants ranged from 1 to
18 days old (5.25 days), and from 1.5 to 4.0 kg (2.9 kg). Conduit length
ranged from 2 to 6 cm (4 cm). Sixteen patients had atresia of the tricuspid
or pulmonary valve. There were 6 early deaths (30%), only 1 of which was
shunt related. The mean preoperative arterial oxygen saturation was 62%
(range, 33 to 80%), and mean postoperative saturation was 87% (range, 78 to
90%). There were 5 late deaths, 1 probably caused by shunt failure. Nine
long-term survivors have done well. Follow-up ranges from 1 to 36 months
(18 months). Factors influencing conduit function are length, technical
considerations, and pulmonary vascular resistance. Late restudy in 5 of 9
survivors confirms patency and demonstrates bidirectional pulmonary blood
flow. Since PTFE shunt flow capability is fixed, the infant may require
repair or a second shunt within 24 months of the initial procedure.
