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Rapid onset of intrapulmonary arteriovenous shunting after surgical repair of tetralogy of Fallot with pulmonary atresia

Published online by Cambridge University Press:  15 August 2006

Victor D. Ofoe ,
Usha Pratap  and
Zdenek Slavik
Victor D. Ofoe
Affiliation:
Royal Brompton and Harefield NHS Trust, Paediatric Surgical Unit, Harefield Hospital, Middlesex, UK
Usha Pratap
Affiliation:
Royal Brompton and Harefield NHS Trust, Paediatric Surgical Unit, Harefield Hospital, Middlesex, UK
Zdenek Slavik
Affiliation:
Royal Brompton and Harefield NHS Trust, Paediatric Surgical Unit, Harefield Hospital, Middlesex, UK
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Abstract

We describe a 2-year-old girl with tetralogy of Fallot and pulmonary atresia, palliated as a neonate with a right modified Blalock Taussig shunt, who developed severe cyanosis following total correction in the absence of corresponding evidence of parenchymal lung disease on the chest X-ray. Selective pulmonary angiography showed new intrapulmonary shunting involving only the right middle and lower lobes only. The cyanosis resolved rapidly subsequent to inhalation of nitric oxide. To our knowledge, this is the first documented case of rapid onset of localised intrapulmonary right-to-left shunting, involving only two lung lobes, following biventricular repair for complex congenital heart disease.

Keywords

cyanosiscomplex congenital heart diseaseintrapulmonary arteriovenous shunting
Type
Brief Report
Information
Cardiology in the Young , Volume 11 , Issue 2 , March 2001 , pp. 236 - 239
Copyright
2001 Cambridge University Press

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