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Right arrow Congenital - cyanotic

Ann Thorac Surg 2003;75:1010-1012
© 2003 The Society of Thoracic Surgeons

Case report

Pulmonary-to-systemic blood flow ratio oriented management after repair of obstructive total anomalous pulmonary venous connection in neonates with single ventricle

Yukihiro Kaneko, MDa*, Yasutaka Hirata, MDb, Kuniyoshi Yagyu, MDa, Arata Murakami, MDa, Shinichi Takamoto, MDa

a Department of Cardiovascular Surgery, Japanese Red Cross Medical Center, Tokyo, Japan
b Department of Cardiothoracic Surgery, University of Tokyo, Tokyo, Japan

Accepted for publication August 27, 2002.

* Address reprint requests to Dr Kaneko, Department of Cardiovascular Surgery, Japanese Red Cross Medical Center, 4-1-22 Hiroo, Shibuya-ku, Tokyo 150-8935, Japan
e-mail: yukihirokaneko{at}hotmail.com

Caval oxygen saturation was monitored to estimate pulmonary-to-systemic blood flow ratio after relief of obstructive total anomalous pulmonary venous connection in two neonates with single ventricle. Distribution between systemic and pulmonary blood flow was manipulated by pharmacologic, ventilatory, and surgical interventions aimed at achieving pulmonary-to-systemic blood flow ratio of 0.5 to 1.0. Monitoring of pulmonary-to-systemic blood flow ratio facilitates appropriate balancing between tissue perfusion and oxygenation, and detects redundant ventricular volume-load.






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