The bidirectional cavopulmonary shunt

J. J. Lamberto, R. L. Spicer, J. D. Waldman, T. M. Grehl, D. Thomson, L. George, S. E. Kirkpatrick, J. W. Mathewson

Research output: Contribution to journalArticle

119 Citations (Scopus)

Abstract

The bidirectional cavopulmonary shunt improves systemic arterial oxygen saturation without increasing ventricular work or pulmonary vascular resistance. Since 1983, 17 patients have undergone a cavopulmonary shunt procedure (five primary operations, 12 secondary operations). Diagnoses were single ventricle complex (n = 4), hypoplastic right heart syndrome (n = 10), and hypoplastic left ventricle (n = 3). Age at primary operation ranged from 3 1/2 to 30 months (median 6 months). Weight ranged from 3.5 to 9.7 kg. Age at secondary operation ranged from 10 months to 14 years (median 15 months). Seven cavopulmonary shunt operations were performed without cardiopulmonary bypass (six via thoracotomy and one via sternotomy) and 10, with cardiopulmonary bypass. All patients in the bypass group had additional procedures: takedown of modified Blalock-Taussig shunt, seven patients; revision of right ventricular outflow tract, four patients; reconstruction of pulmonary arteries, four patients; tricuspid valvuloplasty, one patient; and Damus procedure, one patient. There was one (1/17) operative death (Damus procedure). One patient required early revision. Follow-up ranges from 1 to 53 months (median 23 months). Twelve of 16 had a good to excellent late result, with a rise in mean arterial oxygen saturation from 69% to 83%. Three patients died late (4 to 53 months) (pulmonary vascular disease, pulmonary arteriovenous malformations, and pneumonia, one patient each). There was one late failure (converted to Glenn shunt). The cavopulmonary shunt is an excellent palliative procedure when right atrium-pulmonary artery connection (modified Fontan) must be deferred because of age, weight, or anatomic considerations. Five patients have undergone right atrium-pulmonary artery connection later. In addition, at the time of the modified Fontan operation, the cavopulmonary shunt approach may optimize the anatomic connection (eight additional patients).

Original languageEnglish (US)
Pages (from-to)22-30
Number of pages9
JournalJournal of Thoracic and Cardiovascular Surgery
Volume100
Issue number1
StatePublished - Jan 1 1990

Fingerprint

Fontan Procedure
Right Heart Bypass
Pulmonary Artery
Heart Atria
Cardiopulmonary Bypass
Blalock-Taussig Procedure
Oxygen
Weights and Measures
Sternotomy
Arteriovenous Malformations
Thoracotomy
Vascular Diseases
Vascular Resistance
Lung Diseases
Heart Ventricles
Pneumonia

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Lamberto, J. J., Spicer, R. L., Waldman, J. D., Grehl, T. M., Thomson, D., George, L., ... Mathewson, J. W. (1990). The bidirectional cavopulmonary shunt. Journal of Thoracic and Cardiovascular Surgery, 100(1), 22-30.

The bidirectional cavopulmonary shunt. / Lamberto, J. J.; Spicer, R. L.; Waldman, J. D.; Grehl, T. M.; Thomson, D.; George, L.; Kirkpatrick, S. E.; Mathewson, J. W.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 100, No. 1, 01.01.1990, p. 22-30.

Research output: Contribution to journalArticle

Lamberto, JJ, Spicer, RL, Waldman, JD, Grehl, TM, Thomson, D, George, L, Kirkpatrick, SE & Mathewson, JW 1990, 'The bidirectional cavopulmonary shunt', Journal of Thoracic and Cardiovascular Surgery, vol. 100, no. 1, pp. 22-30.
Lamberto JJ, Spicer RL, Waldman JD, Grehl TM, Thomson D, George L et al. The bidirectional cavopulmonary shunt. Journal of Thoracic and Cardiovascular Surgery. 1990 Jan 1;100(1):22-30.
Lamberto, J. J. ; Spicer, R. L. ; Waldman, J. D. ; Grehl, T. M. ; Thomson, D. ; George, L. ; Kirkpatrick, S. E. ; Mathewson, J. W. / The bidirectional cavopulmonary shunt. In: Journal of Thoracic and Cardiovascular Surgery. 1990 ; Vol. 100, No. 1. pp. 22-30.
@article{38ac694c841f476bbdee34c2b45a5485,
title = "The bidirectional cavopulmonary shunt",
abstract = "The bidirectional cavopulmonary shunt improves systemic arterial oxygen saturation without increasing ventricular work or pulmonary vascular resistance. Since 1983, 17 patients have undergone a cavopulmonary shunt procedure (five primary operations, 12 secondary operations). Diagnoses were single ventricle complex (n = 4), hypoplastic right heart syndrome (n = 10), and hypoplastic left ventricle (n = 3). Age at primary operation ranged from 3 1/2 to 30 months (median 6 months). Weight ranged from 3.5 to 9.7 kg. Age at secondary operation ranged from 10 months to 14 years (median 15 months). Seven cavopulmonary shunt operations were performed without cardiopulmonary bypass (six via thoracotomy and one via sternotomy) and 10, with cardiopulmonary bypass. All patients in the bypass group had additional procedures: takedown of modified Blalock-Taussig shunt, seven patients; revision of right ventricular outflow tract, four patients; reconstruction of pulmonary arteries, four patients; tricuspid valvuloplasty, one patient; and Damus procedure, one patient. There was one (1/17) operative death (Damus procedure). One patient required early revision. Follow-up ranges from 1 to 53 months (median 23 months). Twelve of 16 had a good to excellent late result, with a rise in mean arterial oxygen saturation from 69{\%} to 83{\%}. Three patients died late (4 to 53 months) (pulmonary vascular disease, pulmonary arteriovenous malformations, and pneumonia, one patient each). There was one late failure (converted to Glenn shunt). The cavopulmonary shunt is an excellent palliative procedure when right atrium-pulmonary artery connection (modified Fontan) must be deferred because of age, weight, or anatomic considerations. Five patients have undergone right atrium-pulmonary artery connection later. In addition, at the time of the modified Fontan operation, the cavopulmonary shunt approach may optimize the anatomic connection (eight additional patients).",
author = "Lamberto, {J. J.} and Spicer, {R. L.} and Waldman, {J. D.} and Grehl, {T. M.} and D. Thomson and L. George and Kirkpatrick, {S. E.} and Mathewson, {J. W.}",
year = "1990",
month = "1",
day = "1",
language = "English (US)",
volume = "100",
pages = "22--30",
journal = "Journal of Thoracic and Cardiovascular Surgery",
issn = "0022-5223",
publisher = "Mosby Inc.",
number = "1",

}

TY - JOUR

T1 - The bidirectional cavopulmonary shunt

AU - Lamberto, J. J.

AU - Spicer, R. L.

AU - Waldman, J. D.

AU - Grehl, T. M.

AU - Thomson, D.

AU - George, L.

AU - Kirkpatrick, S. E.

AU - Mathewson, J. W.

PY - 1990/1/1

Y1 - 1990/1/1

N2 - The bidirectional cavopulmonary shunt improves systemic arterial oxygen saturation without increasing ventricular work or pulmonary vascular resistance. Since 1983, 17 patients have undergone a cavopulmonary shunt procedure (five primary operations, 12 secondary operations). Diagnoses were single ventricle complex (n = 4), hypoplastic right heart syndrome (n = 10), and hypoplastic left ventricle (n = 3). Age at primary operation ranged from 3 1/2 to 30 months (median 6 months). Weight ranged from 3.5 to 9.7 kg. Age at secondary operation ranged from 10 months to 14 years (median 15 months). Seven cavopulmonary shunt operations were performed without cardiopulmonary bypass (six via thoracotomy and one via sternotomy) and 10, with cardiopulmonary bypass. All patients in the bypass group had additional procedures: takedown of modified Blalock-Taussig shunt, seven patients; revision of right ventricular outflow tract, four patients; reconstruction of pulmonary arteries, four patients; tricuspid valvuloplasty, one patient; and Damus procedure, one patient. There was one (1/17) operative death (Damus procedure). One patient required early revision. Follow-up ranges from 1 to 53 months (median 23 months). Twelve of 16 had a good to excellent late result, with a rise in mean arterial oxygen saturation from 69% to 83%. Three patients died late (4 to 53 months) (pulmonary vascular disease, pulmonary arteriovenous malformations, and pneumonia, one patient each). There was one late failure (converted to Glenn shunt). The cavopulmonary shunt is an excellent palliative procedure when right atrium-pulmonary artery connection (modified Fontan) must be deferred because of age, weight, or anatomic considerations. Five patients have undergone right atrium-pulmonary artery connection later. In addition, at the time of the modified Fontan operation, the cavopulmonary shunt approach may optimize the anatomic connection (eight additional patients).

AB - The bidirectional cavopulmonary shunt improves systemic arterial oxygen saturation without increasing ventricular work or pulmonary vascular resistance. Since 1983, 17 patients have undergone a cavopulmonary shunt procedure (five primary operations, 12 secondary operations). Diagnoses were single ventricle complex (n = 4), hypoplastic right heart syndrome (n = 10), and hypoplastic left ventricle (n = 3). Age at primary operation ranged from 3 1/2 to 30 months (median 6 months). Weight ranged from 3.5 to 9.7 kg. Age at secondary operation ranged from 10 months to 14 years (median 15 months). Seven cavopulmonary shunt operations were performed without cardiopulmonary bypass (six via thoracotomy and one via sternotomy) and 10, with cardiopulmonary bypass. All patients in the bypass group had additional procedures: takedown of modified Blalock-Taussig shunt, seven patients; revision of right ventricular outflow tract, four patients; reconstruction of pulmonary arteries, four patients; tricuspid valvuloplasty, one patient; and Damus procedure, one patient. There was one (1/17) operative death (Damus procedure). One patient required early revision. Follow-up ranges from 1 to 53 months (median 23 months). Twelve of 16 had a good to excellent late result, with a rise in mean arterial oxygen saturation from 69% to 83%. Three patients died late (4 to 53 months) (pulmonary vascular disease, pulmonary arteriovenous malformations, and pneumonia, one patient each). There was one late failure (converted to Glenn shunt). The cavopulmonary shunt is an excellent palliative procedure when right atrium-pulmonary artery connection (modified Fontan) must be deferred because of age, weight, or anatomic considerations. Five patients have undergone right atrium-pulmonary artery connection later. In addition, at the time of the modified Fontan operation, the cavopulmonary shunt approach may optimize the anatomic connection (eight additional patients).

UR - http://www.scopus.com/inward/record.url?scp=0025299140&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0025299140&partnerID=8YFLogxK

M3 - Article

C2 - 1694938

AN - SCOPUS:0025299140

VL - 100

SP - 22

EP - 30

JO - Journal of Thoracic and Cardiovascular Surgery

JF - Journal of Thoracic and Cardiovascular Surgery

SN - 0022-5223

IS - 1

ER -