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Bidirectional Cavopulmonary Shunt With Accessory Pulmonary Blood Flow

Department of Cardiovascular Surgery Institute of Cardiovascular Diseases Madras Medical Mission Chennai, Tamil Nadu, India
For reprint information contact: Kona Samba Murthy, MCh Tel: 91 44 656 5961 Fax: 91 44 656 5510 email: mmmbits{at}giasmd01.vsnl.net.in Department of Cardiovascular Surgery, Institute of Cardiovascular Diseases, Madras Medical Mission, 4A Dr. J Jayalalitha Nagar, Mogappair, Chennai, Tamil Nadu 600050, India.

Ninety-five patients underwent a bidirectional cavopulmonary shunt between 1995 and 1999. Group 1 (n = 38) had a shunt without an additional source of pulmonary blood flow. Group 2 (n = 57) had a shunt with accessory pulmonary flow. Patients with accessory pulmonary flow were better palliated (82% asymptomatic in group 2 versus 63% in group 1; p = 0.03). Intensive care stay was longer in group 2 (6.9 ± 7.5 days versus 4.6 ± 3.6 days; p = 0.05). There were no differences between the groups in terms of early postoperative oxygen saturation, incidence of pleural effusion, or the need for inotropic support. Leaving an additional source of pulmonary blood flow in selected patients is recommended. These findings are of special significance in developing countries where additional surgery is often unaffordable and a bidirectional cavopulmonary shunt may be the only procedure undertaken.