Optimal Graft Size of Modified Blalock-Taussig Shunt for Biventricular Circulation in Neonates and Small Infants
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- Shibata Miyuki
- Department of Cardiovascular Surgery, Kitasato University School of Medicine
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- Itatani Keiichi
- Department of Cardiovascular Surgery, Kitasato University School of Medicine
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- Oka Norihiko
- Department of Cardiovascular Surgery, Kitasato University School of Medicine
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- Yoshii Takeshi
- Department of Cardiovascular Surgery, Kitasato University School of Medicine
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- Nakamura Yuki
- Department of Cardiovascular Surgery, Kitasato University School of Medicine
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- Kitamura Tadashi
- Department of Cardiovascular Surgery, Kitasato University School of Medicine
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- Horai Tetsuya
- Department of Cardiovascular Surgery, Kitasato University School of Medicine
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- Miyaji Kagami
- Department of Cardiovascular Surgery, Kitasato University School of Medicine
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抄録
The modified Blalock-Taussig shunt (mBTS) is one of the most important palliative procedures in congenital heart surgery. However, in neonates and small infants, operative mortality and morbidity due to excessive pulmonary blood flow or shunt failure remains high. In this study, a small shunt graft (3.0-mm diameter) was estimated to determine the optimal shunt graft size of BTS as an initial palliation for ultimate biventricular circulation. Eighteen patients weighing an average 3.5 kg who underwent mBTS from July 2004 to January 2013 at our institute were reviewed. We divided the study cohort into two groups: group S (n = 10) included patients with 3.0-mm diameter shunt grafts, and group L (n = 8) included patients with 3.5-mm diameter shunt grafts. There were no hospital deaths or shunt occlusion in either group. One group L patient (12.5%) had cardiogenic shock due to excessive pulmonary blood flow. There were no differences in postoperative arterial oxygen saturation (SaO2) between the groups. There were no differences in body weight at intracardiac repair (ICR) between the groups. During the interstage to ICR, body weight gain was significantly greater in group S than in group L (P = 0.008). The small shunt graft (3.0-mm diameter) in BTS was safe, provided adequate pulmonary blood flow, and led to significant weight gain between mBTS and ICR for ultimate biventricular circulation in neonates and small infants with low body weight.
収録刊行物
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- International Heart Journal
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International Heart Journal 56 (5), 533-536, 2015
一般社団法人 インターナショナル・ハート・ジャーナル刊行会
