Systemic pulmonary shunts in neonates: Early clinical outcome and choice of surgical approach

Abdul M. Alkhulaifi*, François Lacour-Gayet, Alain Serraf, Emre Belli, Claude Planché

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

75 Scopus citations

Abstract

Background. Systemic pulmonary shunt remains a major strategy for the palliation of cyanotic lesions in neonates despite the associated morbidity and mortality. Methods. Between March 1993 and December 1998, 79 systemic pulmonary shunts were performed in 75 neonates with cyanosis and severely reduced pulmonary blood flow. The mean age was 11.5 days and the mean weight, 3 kg. All neonates were dependent on duct flow and prostaglandin E1 infusion for adequate oxygenation. Results. The systemic pulmonary shunt was performed through a right thoracotomy in 36 patients, left thoracotomy in 6, and median sternotomy in 33 patients. The 30-day mortality was 3 patients (4%). Univariate and logistic regression analyses revealed a weight less than 2 kg (p = 0.039) and preoperative mechanical ventilation (p = 0.008), to be predictors of early mortality, whereas pulmonary hypoplasia (p = 0.55), diagnostic group (p = 0.79), shunt size (p = 0.2), and surgical approach (p = 0.5) were not. There were seven episodes of shunt-related complications that required early intervention. Conclusions. Systemic pulmonary shunt remains an effective palliative measure in cyanotic neonates despite specific complications. Both low weight and preoperative ventilation represent significant risk factors for early mortality. (C) 2000 The Society of Thoracic Surgeons.

Original languageEnglish
Pages (from-to)1499-1504
Number of pages6
JournalAnnals of Thoracic Surgery
Volume69
Issue number5
DOIs
StatePublished - May 2000
Externally publishedYes

Fingerprint

Dive into the research topics of 'Systemic pulmonary shunts in neonates: Early clinical outcome and choice of surgical approach'. Together they form a unique fingerprint.

Cite this