Document Detail

Possible sources of right-to-left shunting in patients following a total cavopulmonary connection.
MedLine Citation:
PMID:  9731651     Owner:  NLM     Status:  MEDLINE    
Despite a good haemodynamic result, many children have a mildly decreased arterial-oxygen saturation following a total cavopulmonary connection. Our study was performed to determine possible mechanisms of right-to-left shunting in these patients. We performed elective cardiac catheterization in 19 children at a mean interval of 3.6 years following a total cavopulmonary connection. The intrapulmonary right-to-left shunt, the intracardiac right-to-left shunt and the total right-to-left shunt were calculated under mechanical ventilation with 100% oxygen. The intrapulmonary right-to-left shunt was 10.8+/-3.5% of the pulmonary blood flow, and the total right-to-left shunt accounted for 18.9+/-5.2% of the systemic blood flow. The intracardiac right-to-left shunt in patients with no relevant venovenous collaterals or leaks in the atrial tunnel was calculated at 6.4+/-3.0% of the systemic blood flow, while the intracardiac right-to-left shunt in patients with relevant collaterals or leaks accounted for 13.0+/-5.9% of the systemic blood flow. Since intrapulmonary arteriovenous fistulas were not demonstrated angiographically in any of our patients, the intrapulmonary right-to-left shunt is probably due to low ratios of perfusion to ventilation in some pulmonary segments. The intracardiac right-to-left shunt was due to leaks across the interatrial baffle, collaterals between systemic and pulmonary veins, and to the coronary sinus draining to the pulmonary venous atrium.
G Buheitel; M Hofbeck; U Tenbrink; G Leipold; J vd Emde; H Singer
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Cardiology in the young     Volume:  8     ISSN:  1047-9511     ISO Abbreviation:  Cardiol Young     Publication Date:  1998 Jul 
Date Detail:
Created Date:  1998-11-18     Completed Date:  1998-11-18     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9200019     Medline TA:  Cardiol Young     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  358-63     Citation Subset:  IM    
Department of Pediatric Cardiology, University Erlangen-Nürnberg, Germany.
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MeSH Terms
Child, Preschool
Heart Bypass, Right*
Heart Catheterization
Oxygen / blood
Pulmonary Circulation*
Treatment Outcome
Reg. No./Substance:

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