Korean J Thorac Cardiovasc Surg.  2006 Mar;39(3):177-183.

The Clinical Efficacy of Bidirectional Cavopulmonray Shunt in Young Infants

• Lee S
• Park YH
• Park HK
• Hong SC
• Kwak YT
• Cho BK

Abstract

BACKGROUND: The bidirectional cavopulmonary shunt (BCPS) is one of the primary palliative procedures for complex congenital heart disease. It has many advantages, but it is known to have high risks in young infants. MATERIAL AND METHOD: From 1995 to 2003, 48 infants under the age of one year underwent BCPS. All the patients were Fontan candidates due to functional univentricular heart physiology. There were no significant differences in preoperative variables, except in mean age (67.58+/-3.78 vs. 212.91+/-13.44 days), and mean body weight (4.51+/-0.29 vs. 6.62+/-0.27 kg), between group A (<3 months, n=12) and group B (> or=3 months, n=36). RESULT: In group A, the arterial oxygen saturations serially measured were significantly lower. Hospital mortality was 25%, and 19%, respectively. During follow up, there were 2 late mortalities in group A, and 5 in group B.
CONCLUSION
This study showed that operative risk in young infants was comparable to that of older patients, and BCPS could be a good option as a primary palliative procedure, and may eliminate other repeated palliative procedures which could be the risk factors for Fontan candidates. However, in high-risk patients accompanying pulmonary hypertension, or heterotaxia syndrome, other palliative procedures should be considered.

Keyword

Anastomosis, surgical; Congenital heart disease; Shunts

MeSH Terms

Anastomosis, Surgical
Body Weight
Follow-Up Studies
Fontan Procedure
Heart
Heart Defects, Congenital
Hospital Mortality
Humans
Hypertension, Pulmonary
Infant*
Mortality
Oxygen
Physiology
Risk Factors
Oxygen