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Related Experiment Videos

Mid-term results after bidirectional cavopulmonary shunts

J A Hawkins1, R E Shaddy, R W Day

  • 1Department of Surgery, Primary Children's Medical Center, Salt Lake City, Utah.

The Annals of Thoracic Surgery
|October 1, 1993
PubMed
Summary

The bidirectional cavopulmonary shunt offers excellent midterm survival and serves as a valuable staging procedure for high-risk single ventricle patients, facilitating later Fontan conversion in many cases.

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Area of Science:

  • Pediatric Cardiology
  • Congenital Heart Disease Surgery
  • Cardiovascular Physiology

Background:

  • Increasing use of bidirectional cavopulmonary shunt (BCPS) for single ventricle physiology.
  • Limited data on long-term outcomes and Fontan conversion rates after BCPS.

Purpose of the Study:

  • To evaluate the late results, palliation duration, and Fontan conversion success after BCPS.
  • To assess survival and reoperation rates in high-risk pediatric patients undergoing BCPS.

Main Methods:

  • Retrospective review of 38 children (4 months to 16 years) with single ventricle physiology undergoing BCPS (1984-1992).
  • Analysis of pre- and post-operative oxygen saturation, survival data, and subsequent procedures.
  • Assessment of conversion to Fontan or fenestrated Fontan procedures.

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Main Results:

  • Improved oxygen saturation from 75% to 82% (p < 0.05) at 24 months post-BCPS.
  • Actuarial survival of 86% at 1 year and 81% at 6 years.
  • Successful Fontan conversion in 58% (21/36) of survivors, with low operative mortality (4.8%).

Conclusions:

  • BCPS demonstrates excellent midterm survival and effective palliation for high-risk single ventricle patients.
  • BCPS serves as a suitable staging procedure, enabling successful Fontan conversion in a significant proportion of patients.