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Use of the bidirectional cavopulmonary shunt in patients under one year of age

Published online by Cambridge University Press:  19 August 2008

Juan Calderón-Colmenero ,
Samuel Ramírez ,
Maria Rijlaarsdam ,
Alfonso Buendia ,
Carlos Zabal ,
Ernesto Zarco-Martínez  and
Fause Attie
Juan Calderón-Colmenero*
Affiliation:
From the Instituto Nacional de Cardiología “Ignacio Chávez,”, México
Samuel Ramírez
Affiliation:
From the Instituto Nacional de Cardiología “Ignacio Chávez,”, México
Maria Rijlaarsdam
Affiliation:
From the Instituto Nacional de Cardiología “Ignacio Chávez,”, México
Alfonso Buendia
Affiliation:
From the Instituto Nacional de Cardiología “Ignacio Chávez,”, México
Carlos Zabal
Affiliation:
From the Instituto Nacional de Cardiología “Ignacio Chávez,”, México
Ernesto Zarco-Martínez
Affiliation:
From the Instituto Nacional de Cardiología “Ignacio Chávez,”, México
Fause Attie
Affiliation:
From the Instituto Nacional de Cardiología “Ignacio Chávez,”, México
*
Dr. Juan Calderón-Colmenero, Instituto Nacional de Cardiologia “Ignacio Chavez,” Juan Badiano I, Tlalpan, 14080 México, D.F., México.
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Summary

Between January 1990 and March 1992, a bidirectional cavopulmonary shunt was performed in seven patients under one year of age for palliation of complex cyanotic congenital heart disease. Five cases had tricuspid atresia with a restrictive ventricular septal defect. One case presented with complete mirror imagery, right-sided heart, double inlet and double outlet right ventricle with pulmonary stenosis. Another case had isomerism of the left atrial appendages with common atrioventricular valve and double outlet right ventricle. All had a pulmonary arterial index greater than 250 mm/m2 (Nakata index). Age and weights before surgery averaged five months (one to 11 months) and 5.6 kg (range 2.8 to 8.5 kg) respectively. Preoperative mean arterial oxygen saturation measured by cardiac catheterization was 60.05±14% and postoperative mean arterial oxygen saturation on room air was 79.85±6.03% (p<0.05). There were no deaths, although postoperative complications occurred in three patients, namely pleural effusion and pneumothorax. Mean follow-up was 10±4.2 months. The cardiothoracic ratio decreased in all cases. On subsequent echocardiographic studies with pulsed Doppler sampling, low velocity systolic-diastolic forward flow was registered in the pulmonary trunk. The velocity of flow increased clearly during inspiration. The bidirectional cavopulmonary shunt can be considered as primary palliation for complex cardiac malformations with restricted pulmonary flow independent of age and body weight.

Keywords

Bidirectional cavopulmonary shunt
Type
Original Articles
Information
Cardiology in the Young , Volume 5 , Issue 1 , January 1995 , pp. 28 - 30
Copyright
Copyright © Cambridge University Press 1995

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