RE: [HSF] BT shunt – neonate

[ghassan ????? baslaim]

I believe a BT shunt on CPB is a safe procedure if indicated and there is no need to resist CPB for a short run. Most of the centers are performing BTs thru med sternotomy since redo surgery is not a major issue. Situations are: unstable patient, absence of PDA/collateral or forward flow, intracardiac procedure, pulmonary artery reconstruction and unifocalization.
 
In single ventricle anomaly one tends to lean toward a smaller shunt to avoid the hastle of excessive flow and optimize the condition for the cavopulmonary connections. Also, in late presenters with cyanotic biventricular lesions, large shunts may compromise a dysfunctional ventricle with volume overload. Intra-op ssessment of Qp/Qs amy not be accurate.
Rough idea (body Wt ... shunt size):
< 3 kg .... 3.5
3-5 kg ... 4
5-10 ... 5
> 10 ... 5-6
Size 3 shunt tends to clot easily
 
Good luck,
 
G. Baslaim, MD
Jeddah, KSA
  > Date: Sat, 26 Jan 2008 08:54:42 -0800> From: jamesle2007 at yahoo.com> To: OpenHeart-L at lists.hsforum.com> CC: > Subject: [HSF] BT shunt – neonate > > > > What are the situations when we may need CPB to perform BT shunt in neonates? > > How can we assess excessive flow from the shunt before it leads to elevation of serum lactate? Can ECHO assessment help? > > > > ---------------------------------> Be a better friend, newshound, and know-it-all with Yahoo! Mobile. Try it now.> _______________________________________________> OpenHeart-L mailing list> > Send postings to:> OpenHeart-L at lists.hsforum.com> > To UNSUBSCRIBE, to CHANGE email address, or to view archives:> http://mmp.cjp.com/mailman/listinfo/openheart-l> > All messages transmitted by the OpenHeart-L are subject to the policies and > disclaimers posted at:> http://www.hsforum.com/listdisclaim> -----------------------------------------
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