A current appraisal of the Waterston shunt

C. E. Garcia, P. H. Kay, G. L. Grunkemeier, P. A. Abbruzzese, A. Cobanoglu, Albert Starr

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Recent reports have suggested that the classical Blalock-Taussig shunt and its prosthetic modification have a low patency rate in neonates. This prompted a review of 58 neonates undergoing a Waterston shunt for cyanotic congenital heart disease. The 4 mm anastomosis was constructed using a calibrated clamp. There were 20 (35%) hospital deaths, of which 3 were directly related to shunt failure. Operative mortality was associated with increasing complexity of the cardiac lesion, emergency operation, weight less than 3 kg and age less than 48 hours. There were 5 late deaths resulting in an actuarial survival of 52% at ten years. There was one case of late occlusion corresponding to a patency of 92% at 2 years. Anastomotic kinking with preferential flow to one lung occurred in 2 (7%) of 28 patients undergoing repeat angiography at 3 and 5 years respectively. Nineteen patients underwent corrective surgery a mean of 27 months after shunt construction. Six (32%) required an angioplastic repair of the pulmonary artery. Six (16%) of the 38 operative survivors required diuretic therapy for excessive pulmonary flow. The high patency ensures that the Waterston shunt continues to play an important role in the management of low weight neonates who require an emergency systemic-pulmonary shunt. The use of a calibrated clamp reduces the incidence of excessive pulmonary flow. Early corrective surgery and shunt dismantling may reduce the necessity for angioplastic repair.

Original languageEnglish (US)
Pages (from-to)604-608
Number of pages5
JournalJournal of Cardiovascular Surgery
Volume27
Issue number5
StatePublished - 1986
Externally publishedYes

Fingerprint

Lung
Newborn Infant
Emergencies
Blalock-Taussig Procedure
Weights and Measures
Diuretics
Pulmonary Artery
Survivors
Heart Diseases
Angiography
Survival
Mortality
Incidence
Therapeutics

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Garcia, C. E., Kay, P. H., Grunkemeier, G. L., Abbruzzese, P. A., Cobanoglu, A., & Starr, A. (1986). A current appraisal of the Waterston shunt. Journal of Cardiovascular Surgery, 27(5), 604-608.

A current appraisal of the Waterston shunt. / Garcia, C. E.; Kay, P. H.; Grunkemeier, G. L.; Abbruzzese, P. A.; Cobanoglu, A.; Starr, Albert.

In: Journal of Cardiovascular Surgery, Vol. 27, No. 5, 1986, p. 604-608.

Research output: Contribution to journalArticle

Garcia, CE, Kay, PH, Grunkemeier, GL, Abbruzzese, PA, Cobanoglu, A & Starr, A 1986, 'A current appraisal of the Waterston shunt', Journal of Cardiovascular Surgery, vol. 27, no. 5, pp. 604-608.
Garcia CE, Kay PH, Grunkemeier GL, Abbruzzese PA, Cobanoglu A, Starr A. A current appraisal of the Waterston shunt. Journal of Cardiovascular Surgery. 1986;27(5):604-608.
Garcia, C. E. ; Kay, P. H. ; Grunkemeier, G. L. ; Abbruzzese, P. A. ; Cobanoglu, A. ; Starr, Albert. / A current appraisal of the Waterston shunt. In: Journal of Cardiovascular Surgery. 1986 ; Vol. 27, No. 5. pp. 604-608.
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