Document Detail


Reduced frequency of occlusion of aorto-pulmonary shunts in infants receiving aspirin.
MedLine Citation:
PMID:  10535826     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Infants with severely reduced pulmonary perfusion due to complex congenital cardiac malformations are in need of an improved flow of blood to the lungs. One option for treatment is to construct a systemic-to-pulmonary arterial shunt. Although such shunts have been used since 1945, their spontaneous occlusion remains a major problem in the long-term. DESIGN: We studied all infants in whom a systemic-to-pulmonary arterial shunt had been constructed using a Gore-Tex tube graft between December 1989 and March 1996. PATIENTS: Of 46 infants undergoing construction of a shunt, 7 (15%) died within 30 days of surgery. The shunts had to be taken down in 2 infants. Thus, 37 infants were included in the study. All but three infants received Aspirin. Aspirin was discontinued on the personal decision of individual physicians. Of 22 infants, 3 never received Aspirin, and in 19 it was stopped well before undertaking subsequent surgery. Aspirin was administered continuously to 15 infants until further surgery. RESULTS: Those in whom Aspirin was discontinued, or not given, and those receiving Aspirin until further surgery, were comparable concerning their age, time of follow-up, severity of the cardiac lesions, and size and type of shunt. Partial or complete occlusion of the shunt occurred in 2 of 15 (13%) infants taking Aspirin, but was seen in 12 of 22 (54%) infants in whom Aspirin was discontinued. Of these, 3 died due to acute occlusion of the shunt. CONCLUSIONS: Aspirin reduced effectively the rate of occlusion of systemic-to-pulmonary arterial shunts, and should be continued as long as the shunt is in place.
Authors:
R Motz; A Wessel; W Ruschewski; J Bürsch
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Cardiology in the young     Volume:  9     ISSN:  1047-9511     ISO Abbreviation:  Cardiol Young     Publication Date:  1999 Sep 
Date Detail:
Created Date:  1999-11-23     Completed Date:  1999-11-23     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9200019     Medline TA:  Cardiol Young     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  474-7     Citation Subset:  IM    
Affiliation:
Clinic for Paediatric Cardiology, Georg-August-University, Göttingen, Germany. motzrhc@aon.at
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MeSH Terms
Descriptor/Qualifier:
Aorta / surgery
Arteriovenous Shunt, Surgical
Aspirin / therapeutic use*
Case-Control Studies
Female
Graft Occlusion, Vascular / prevention & control*
Heart Defects, Congenital / mortality,  surgery
Humans
Infant
Male
Platelet Aggregation Inhibitors / therapeutic use*
Polytetrafluoroethylene
Prospective Studies
Pulmonary Artery / surgery
Retrospective Studies
Chemical
Reg. No./Substance:
0/Platelet Aggregation Inhibitors; 50-78-2/Aspirin; 9002-84-0/Polytetrafluoroethylene
Comments/Corrections
Comment In:
Cardiol Young. 1999 Sep;9(5):462   [PMID:  10535823 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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