Central (garland) aortopulmonary shunt

A 24-year-old woman, with unoperated tetralogy of Fallot, presented with refractory cyanosis and was listed for emergency palliative shunt surgery. Preoperative cardiac catheterisation or CT angiography could not be performed. The size of the pulmonary artery (PA) appeared borderline on echocardiographic assessment. A central shunt, connecting the ascending aorta to the main PA, was created using a 6 mm polytetrafluoroethylene (PTFE) prosthesis. The central shunt was chosen because it was an emergency procedure, the sizes of the left and right PAs (LPA, RPA) were borderline, and there were multiple collaterals from the subclavian artery. The patient's condition stabilised and she was discharged with a plan for corrective surgery on follow-up. At 6 months post-surgery, she was asymptomatic with an arterial oxygen saturation of 80% at room air. Cardiac auscultation revealed a continuous murmur suggestive of a patent shunt. Preoperative catheterisation demonstrated a patent garland shaped central shunt (figure 1A,...
Source: Heart Asia - Category: Cardiology Authors: Tags: Images in cardiovascular medicine Source Type: research