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Ann Thorac Surg 2002;74:1700-1702
© 2002 The Society of Thoracic Surgeons

Case report

Nitric oxide: lifesaving measure for pulmonary vasospasm after modified Blalock-Taussig shunt

Rajeev Gulati, MDa, William A. Lell, MDb, Albert D. Pacifico, MDa*, Walter H. Johnson, Jr, MDc, Edward V. Colvin, MDc, Ashwani Bhardwaj, MDa

a Divisions of Cardiovascular and Thoracic Surgery, The University of Alabama at Birmingham, Birmingham, Alabama, USA
b Anesthesia, The University of Alabama at Birmingham, Birmingham, Alabama, USA
c Pediatric Cardiology, The University of Alabama at Birmingham, Birmingham, Alabama, USA

Accepted for publication June 20, 2002.

* Address reprint requests to Dr Pacifico, Division of Cardiovascular and Thoracic Surgery, University of Alabama at Birmingham, Suite 760 THT, 1900 University Blvd, Birmingham, AL, 35226, USA.
e-mail: albert.pacifico{at}ccc.uab.edu

Pulmonary vasospasm and hypertension may occur after repair or palliation of congenital cardiac defects, and can be fatal in spite of conventional treatment. Nitric oxide has been shown to improve pulmonary hypertension unresponsive to conventional measures after a variety of repairs, but use has infrequently been reported after palliative systemic to pulmonary artery shunts. We report a case of pulmonary hypertension and life threatening desaturation after a modified Blalock–Taussig shunt that responded rapidly to inhaled nitric oxide. Clinical use, further study, and prospective analysis of prophylactic use of nitric oxide appear warranted.






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