Systemic-Pulmonary Arterial Shunts

Results of systemic to pulmonary arterial shunts during the first year of life are reported in 86 infants under one year of age. Survival rates were highest in older patients and among infants whose basic cardiac defects were considered to be eventually amenable to surgical repair. Persistent hypoxia accounted for the majority of deaths. Congestive heart failure secondary to too large anastomoses occurred in 32.5% of Waterston shunts, but could be successfully managed medically in the majority of patients. Surgical revision of the shunt was accomplished successfully in two infants with subsequent alleviation of symptoms. Congestive heart failure occurred in only one of 26 patients after a Blalock shunt. Ten of the twelve patients in this series survived openheart repair for cardiac lesions. It will eventually be necessary to compare these data with the results of single stage corrective surgery in the infant group.