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Ann Thorac Surg 1984;37:88-91
© 1984 The Society of Thoracic Surgeons

Articles

Subclavian—Pulmonary Artery Shunts with Polytetrafluoroethylene Interposition Grafts

Edward L. Bove, M.D.1, Henry M. Sondheimer, M.D., Rae-Ellen W. Kavey, M.D., Craig J. Byrum, M.D., Marie S. Blackman, M.D., Frederick B. Parker, Jr., M.D.

From the Divisions of Cardiopulmonary Surgery and Pediatric Cardiology, State University of New York, Upstate Medical Center, Syracuse, NY

Accepted for publication May 18, 1983.

Systemic-pulmonary artery shunts remain an important treatment in cyanotic patients. Central shunts continue to pose early and late problems when standard Blalock-Taussig shunts are not possible. Twenty patients underwent subclavian-pulmonary artery shunt procedures with polytetrafluoroethylene (PTFE) prostheses between October, 1980, and August, 1982. Their ages ranged from 1 day to 15 years; 11 patients were less than 14 days old. The arterial oxygen tension rose from 30.7 ± 11.9 mm Hg to 51.3 ± 9.1 mm Hg (standard deviation; p < 0.001) and from 26.4 ± 7.5 mm Hg to 50.5 ± 9.3 mm Hg (p < 0.001) among the 11 neonates. There were no hospital deaths and only 2 late deaths (not shunt related). All patients have patent shunts and excellent relief of cyanosis.

The 18 survivors have been followed for an average of 19 months (range, 7 to 29 months). No patient has required reoperation for shunt inadequacy or thrombosis. Recatheterization in 11 patients has demonstrated normal pulmonary pressures and good pulmonary artery growth without vessel distortion. Subclavian-pulmonary shunts using PTFE provide long-term palliation in cyanotic patients. This type of shunt appears to offer important advantages over other shunt procedures, including the classic Blalock-Taussig operation, in newborns.




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