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- W2028703182 abstract "During a 12 year period from 1978 to 1989, 35 infants under 4 weeks of age underwent palliative surgery for complex congenital cyanotic heart disease with a short (1-1.5cm) PTFE graft between the ascending aorta and the right pulmonary artery (modified Waterston shunt). Twenty-three infants had pulmonary atresia and 14 had severe pulmonary stenosis. Underlying cardiac lesions were tetralogy of Fallot (n = 11), single ventricle (n = 7), transposition complexes (n = 6), and intact ventricular septum and hypoplastic right heart syndrome (n = 13). There were 4 early deaths (10.7%) in the entire series, 2 of which were shunt related. Three of the 4 occurred during our initial experience with this shunt in 1978 and 1979. They led to the modified Waterston shunt being abandoned for 3 years in favor of other shunt procedures. Since 1983 one early death occurred in 28 infants (3.5% mortality) with no death in the latest 26 patients. All patients were followed up between 6 and 108 months. There were 4 late deaths, one of which was shunt related. We observed a significant difference in the shunt patency rate between 4 and 5 mm grafts: palliation was adequate after 2 years in 5 2 % of the patients when a 4 mm graft was used and in 89% of the 5mm graft group (p < 0.005). Reshunting was necessary in 7 infants between 5 and 60 months after primary surgery. Recatheterization was performed in 17 infants for suspected shunt failure (n = 6) or diagnostic reasons (n = 11). A right pulmonary distortion was found in 2 cases which needed reconstruction of the right pulmonary artery in 1 infant during a consecutive modified Fontan procedure and in another for a preferential flow to the right lung which was observed during recatheterization. Four infants had corrective-surgery or definitive palliation with no operative mortality and another 3 infants are scheduled for definitive procedures. In conclusion, the modified Waterston shunt with a short PTFE graft is easy to construct with an acceptably low mortality rate. The use of 4mm grafts results in a high reshunting rate. Therefore we would recommend even in small infants the use of 5 mm grafts whenever possible." @default.
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- W2028703182 date "1991-10-01" @default.
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- W2028703182 title "Early and Late Results of the Modified Waterston Shunt with PTFE Grafts for Palliation of Complex Congenital Cyanotic Heart Disease in Neonates" @default.
- W2028703182 doi "https://doi.org/10.1055/s-2007-1019984" @default.
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