Outcome in infants less than 3 kilograms for placement of saphenous venous homografts as systemic-to-pulmonary arterial shunts

Abstract

Systemic-to-pulmonary arterial shunts can be constructed safely in infants with biventricular physiology born with low weight. Those having functionally univentricular circulations carry an increased rate of mortality for the period of shunting. Using the saphenous venous homograft permits use of smaller grafts, which does not significantly increase the risk for thrombosis or survival when compared to previous studies using polytetrafluoroethylene grafts.

Outcomes of systemic to pulmonary artery shunts in patients weighing less than 3 kg: Analysis of shunt type, size, and surgical approach

“…Discharge survival was 84.4% in patients weighing 2-2.5 kg and 89% in all patients weighing less than 3 kg. Another report by Erez and colleagues 19 evaluated outcomes using saphenous vein homografts as shunts in patients weighing less than 3 kg. In that series of 32 patients, hospital survival was approximately 94%, but overall survival was approximately 80%.…”

Cryopreserved Saphenous Vein Compared With PTFE Graft for Use as Modified Blalock-Taussig or Central Shunt in Cyanotic Congenital Heart Disease

“…Shunt occlusion and shunt thrombosis have been one of the major concerns in using the saphenous vein, but literature shows lower rates of shunt thrombosis using SVG. [5][6][7] In contrast, previous studies with PTFE conduit have shown higher thrombosis rates ranging from 8% to 22%. 3,[8][9][10][11][12] This is reaffirmed with the results of our study using a larger cohort with thrombosis rate in mBTS patients of 5% in the SVG and 21% in the PTFE group.…”

Homograft saphenous vein versus polytetrafluoroethylene graft for modified Blalock -Taussig shunt

“…Additionally it should be inexpensive and should promote good pulmonary artery growth, should not produce distortion and should be easy to take down. Encouraged by its use in coronary artery bypass grafting 11,13,14 and peripheral vessel revascularization 15,16 , homograft SVG has been used as a substitute for BTS with variable results [5][6][7][8] . Inspired by these reports we conducted this randomized controlled trial.…”

“…Today, modified Blalock Taussig shunt has almost replaced other systemic to pulmonary shunts. There has been an increasing interest in using a homograft saphenous vein (SVG) [5][6][7][8] as an alternative to the PTFE graft. The claimed advantages of this substitute are ease of suturing, less needle hole bleeding, availability in all sizes, less incidence of peri-graft seroma formation and relative resistance to infection 5,8 .…”