Single Ventricle Lesions

Fifteen-minute consultation: Assessing the child with a Blalock-Taussig shunt who is unwell in a district general hospital

“…Shunt placement allows prostaglandin therapy discontinuation by establishing relatively stable pulmonary blood flow 2. This affords a period of growth, allowing full postnatal adaptation and pulmonary vascular resistance (PVR) to fall before further palliation with a superior cavopulmonary shunt is performed between 3 and 6 months of age 3 6.…”

“…This affords a period of growth, allowing full postnatal adaptation and pulmonary vascular resistance (PVR) to fall before further palliation with a superior cavopulmonary shunt is performed between 3 and 6 months of age 3 6. The period between palliative surgical procedures is known as interstage, during which children are potentially discharged home 2…”

“…A univentricular circulation exists if both pulmonary and systemic circulations are parallel and supplied by a single ventricle cardiac output (figure 1). 2 4 The proportion of cardiac output supplying each circulation is governed by its respective resistance 2 4. Pulmonary blood flow (Qp) increases if PVR falls or systemic vascular resistance (SVR) rises.…”

“…Variables affecting circulatory resistance may be dynamic through vascular tone modification, or fixed, such as residual anatomical obstructions (figure 2). 2…”

“…Univentricular heart disease accounts for ~1.25% of all congenital heart disease 1. Such cases remain among the most challenging to manage, typically requiring a three-staged palliation 1 2. The first stage involves placement of a systemic to pulmonary shunt 3.…”