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John J. Lamberti
Charles Campbell
Robert L. Replogle
Constantine Anagnostopoulos
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Ann Thorac Surg 1979;28:568-577
© 1979 The Society of Thoracic Surgeons


Articles

The Prosthetic (Teflon) Central Aortopulmonary Shunt for Cyanotic Infants Less Than Three Weeks Old: Results and Long-Term Follow-up

John J. Lamberti, M.D.*, Charles Campbell, M.D., Robert L. Replogle, M.D., Constantine Anagnostopoulos, M.D., Chung-Yuan Lin, M.D., Pipit Chiemmongkoltip, M.D., Rene Arcilla, M.D.

From the Departments of Surgery and Pediatric Cardiology, the University of Chicago Pritzker School of Medicine, and the Michael Reese Hospital and Medical Center, Chicago IL.

* Address reprint requests to Dr. Lamberti, 7920 Frost St, Suite 304, San Diego, CA 92123.

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 ([image] days), and from 1.5 to 4.0 kg ([image] kg). Conduit length ranged from 2 to 6 cm ([image] 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 ([image] 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.




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