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• W2111760673 abstract "Thirty-four patients operated on for ASD were examined per- and postoperatively, and a residual shunt was demonstrated in 13 cases. Likewise 15 patients who had radical correction of Steno-Fallot's Tetralogy were examined: 7 were found to have residual shunts. Two of these patients died shortly after operation. The 18 patients surviving with residual intracardiac shunts were re-examined 18 months to 4 years after the operation. The applied dye-dilution technique is described. All veno-arterial shunts, up to 30%, had closed spontaneously or decreased to become haemodynamically insignificant, but 1 patient developed an arterio-venous shunt of 50% due to spontaneous postoperative rupture of the defect. Of arterio-venous residual shunts, 6 out of 9 remained unaltered or enlarged after operation for ASD. In tetralogy of Steno-Fallot three residual left-to-right shunts disappeared, one diminished and one remained unchanged. Where a patch is used for closure of the defect no residual shunt should be tolerated. Clinical examination supplemented with ECG, phonocardiography and X-ray of the chest can neither prove nor exclude the presence of a residual shunt. The importance is stressed of controlling per- and postoperatively with dye-dilution technique all patients operated on for intracardiac shunts.At follow-up studies after correction of atrial septal defects (ASD) and radical operation for Steno-Fallot's Tetralogy (SF), residual shunts were found in 7 to 10 % of cases with ASD (Sellers et al., 1966; Rackley et al., 1967; Johansson & Söderlund, 1968) and 17 to 35% of cases with SF (Albertal et al., 1964; Lillehei et al., 1964; Wolf et al., 1965). In an earlier publication (Uhrenholdt et al., 1967), we have shown that 14 out of 28 patients had residual shunts in a material operated upon for various types of congenital heart diseases. None of these patients were re-operated, the risk being considered too great or the shunt regarded as being of minor haemo-dynamic importance.Morrow et al. (1966) showed that only 20% of residual shunts found immediately after operation for various congenital cardiac defects closed spontaneously, and also stated that patients with residual shunts of haemodynamic significance had a postoperative mortality twice as high as patients without shunts.The purpose of this paper is to report the re-examination of patients with known residual intracardiac shunts in order to evaluate possible changes in the size of shunt, and especially to investigate whether any had changed to such an extent that recardiotomy might rather have been performed as soon as the shunt was demonstrated peroperatively." @default.
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• W2111760673 date "1974-01-01" @default.
• W2111760673 modified "2023-10-14" @default.
• W2111760673 title "A Study of Postoperative Residual Intracardiac Shunts with Serial Dye-Dilution Recordings" @default.
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• W2111760673 doi "https://doi.org/10.3109/14017437409129060" @default.
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