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(Circulation. 1971;43:580.)
© 1971 American Heart Association, Inc.

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Ascending Aorta-Right Pulmonary Artery Shunt in Infants and Older Patients with Certain Types of Cyanotic Congenital Heart Disease

WILLIAM F. BERNHARD M.D.¹; JIMMY E. JONES M.D.¹; DAVID Z. FRIEDBERG M.D.¹; S. BERT LITWIN M.D.¹

¹ From the Departments of Cardiovascular Surgery and Cardiology, Children's Hospital Medical Center and the Department of Surgery, Harvard Medical School.

A side-to-side anastomosis between the ascending aorta and the right pulmonary artery was created in 80 infants (less than 1 year of age) and in 61 older children with a variety of cyanotic cardiac abnormalities in which there is pulmonary stenosis or atresia. Seventy-one per cent of the infant group and 90% of patients over 1 year of age were long-term survivors (up to 6 years).

Tetralogy of Fallot was the most commonly encountered anomaly in all 141 patients (66%); transposition of the great vessels and pulmonary stenosis occurred in 18%; and tricuspid atresia with pulmonary stenosis in 10%.

The presence of an excessively large shunt anastomosis (55% of deaths) and additional (unrecognized) other anomalies (26%) were major causes of postoperative deaths.

In patients in whom a systemic-pulmonary artery anastomosis is required, this operation is the procedure of choice in infants under 1 year of age. It is also of value in older patients if a Blalock-Taussig shunt cannot be performed.

Key Words: Infant shunts

Submitted on September 21, 1970
Accepted on December 17, 1970

This article has been cited by other articles:

				D. Z. Friedberg and S. B. Litwin Cardiology Review : The Medical and Surgical Management of Patients with Congenital Heart Disease: A Survey of Current Knowledge and Practices Clinical Pediatrics, April 1, 1976; 15(4): 324 - 333. [Abstract] [PDF]