Ventriculoperitoneal (VP) shunt is one of the most common pediatric neurosurgical procedures. It has various complications that may have serious consequences such as shunt dysfunction, and unusual migration. Although, migration of shunt catheter to bladder, heart, umbilicus, rectum, pulmonary artery, and stomach has been reported, migration to vagina is a rare one.In this report we present a 16...

Between June 1978 and January 1982, 115 patients underwent 122 subclavian artery-pulmonary artery shunts using polytetrafluoroethylene (PTFE Impra) grafts. Forty-six of the patients had a ductus dependent pulmonary circulation, the patency of which was maintained by an infusion of prostaglandin E2 in 29 cases. There were nine hospital deaths, four of which were related to shunt failure. Five pa...

The purpose of this study was to validate a two-dimensional range-gated Doppler echocardiographic method for measurement of pulmonary and systemic blood flow in a canine model with a surgically created extracardiac systemic-to-pulmonary shunt, the size of which could be varied. In five anesthetized open-chest dogs, a previously calibrated electromagnetic (EM) flowmeter was placed around the asc...

BACKGROUND We investigated the acute vasodilator effects of i.v. fasudil, a specific Rho-kinase inhibitor, on pulmonary circulation in patients with congenital heart defects (CHD) and severe pulmonary arterial hypertension (PAH). METHODS AND RESULTS Thirty-five patients (34.23±12.10 years old) with CHD and severe PAH were consecutively enrolled. All patients underwent heart catheterization. A...

Hypoplastic left heart syndrome is the most common lethal cardiac malformation of the newborn. Its treatment, apart from heart transplantation, is the Norwood operation. The initial procedure for this staged repair consists of reconstructing a circulation where a single outlet from the heart provides systemic perfusion and an interpositioning shunt contributes blood flow to the lungs. To better...

Abstract A rare case of a pulmonary arterio-venous malformation not requiring treatment is reported. An incidental peripheral right lower lobe intrapulmonary was identified on computed tomography. On catheter angiography, no artery supply identified. Systemic arteriography systemic arterial from conjoined inferior phrenic with venous drainage to the left atrium. Due this lung abnormality being ...

OBJECTIVE The right ventricle-to-pulmonary artery (RV-PA) shunt in the Norwood procedure (NP) for children with hypoplastic left-heart syndrome (HLHS) provides stable early hemodynamics and improves survival in many centers. However, lower pulmonary-to-systemic flow ratio causes early cyanosis and may require earlier second-stage procedure. The aim of the study was to present shunt-related resu...

We studied the effect on the circulation of the catecholamines isoproterenol, dopamine, and dobutamine in chronically instrumented lambs with aortopulmonary left-to-right shunts (ages 11 to 87 days) and without shunts (ages 8 to 97 days). Infusion of 0.1 microgram/kg/min isoproterenol or 10 micrograms/kg/min dobutamine markedly increased heart rate and systemic and pulmonary blood flows, while ...

BACKGROUND Infants with cyanotic congenital heart disease palliated with placement of a systemic-to-pulmonary-artery shunt are at risk for shunt thrombosis and death. We investigated whether the addition of clopidogrel to conventional therapy reduces mortality from any cause and morbidity related to the shunt. METHODS In a multicenter, double-blind, event-driven trial, we randomly assigned in...

Cyanotic congenital heart defects (CCHD) with severe pulmonary stenosis or atresia exhibit hypoxemia and cyanosis secondary to pulmonary oligemia and right-to-left shunt. Even though a substantial proportion of these patients can be surgically corrected at presentation, such correction is not feasible in some patients either because of the age and size of the patient at presentation or because ...