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Late systemic desaturation after total cavopulmonary shunt operations
O Stümper1, J G Wright, M Sadiq
1Heart Unit, Birmingham Children's Hospital.
British Heart Journal
|September 1, 1995
Summary
Total cavopulmonary shunt (TCPC) operations in children with complex heart defects can lead to systemic venous collaterals, causing significant desaturation. Transcatheter embolisation of these vessels offers effective relief and improves oxygen saturation.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Surgery
- Vascular Interventions
Background:
- Total cavopulmonary shunt (TCPC) offers interim palliation for complex congenital heart disease.
- Long-term outcomes after TCPC in specific pediatric populations remain underreported.
Purpose of the Study:
- To evaluate the medium-term results of TCPC operations.
- To identify complications and assess outcomes in children with left atrial isomerism and interrupted inferior vena cava.
Main Methods:
- Follow-up of six pediatric patients undergoing TCPC.
- Assessment of clinical status, oxygen saturation (rest and exercise), and cardiac catheterization findings.
- Intervention via transcatheter embolisation for identified complications.
Main Results:
- No early or late mortality observed.
- Development of systemic venous to hepatic venous collaterals in 75% of patients, leading to significant desaturation.
- Successful transcatheter embolisation improved oxygen saturation by 6-10%.
Conclusions:
- Systemic venous to hepatic venous collaterals are a frequent complication post-TCPC.
- These collaterals significantly impair oxygenation during rest and exercise.
- Transcatheter embolisation is an effective treatment for improving outcomes.