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J Thorac Cardiovasc Surg 2006;131:e7-e8
© 2006 The American Association for Thoracic Surgery

Brief Communication

Incidence and outcome of cardiopulmonary resuscitation in patients with shunted single ventricle: Advantage of right ventricle to pulmonary artery shunt

Eric M. Graham, MD a , Geoffrey A. Forbus, MD a , Scott M. Bradley, MD b , Girish S. Shirali, MBBS a , Andrew M. Atz, MD a , *

a Division of Pediatric Cardiology, Medical University of South Carolina, Charleston, SC
b Division of Cardiothoracic Surgery, Medical University of South Carolina, Charleston, SC

Received for publication November 18, 2005; accepted for publication December 22, 2005.

* Address for reprints: Andrew M. Atz, MD, Medical University of South Carolina, 165 Ashley Avenue, PO Box 250915, Charleston, SC 29425 (Email: atzam@musc.edu).

The first 20% of the full text of this article appears below.

Appropriate balance among systemic, pulmonary, and coronary blood flow is critical to survival after neonatal palliation in patients with single ventricle physiology. These patients are at risk for circulatory collapse necessitating the use of cardiopulmonary resuscitation (CPR). 1 Go Mortality rates are high when CPR is needed. 2 Go Although the cause of the mortality has remained elusive, autopsy studies suggest impairment of coronary blood flow as a leading cause. 3 Go Greater circulatory stability has been speculated with the right ventricle to pulmonary artery shunt (RV-PA) in comparison with a modified Blalock-Taussig shunt (BTS). 4 Go A purported advantage of the RV-PA is elimination of diastolic runoff, with possible improved coronary perfusion. The differences between these 2 surgical approaches on the incidence and outcome of cardiac arrest in patients requiring CPR were investigated.

Clinical Summary

Between January 2000 and March 2005, 112 patients with single ventricle physiology underwent palliation with a BTS (n = 75) or an RV-PA (n = 37). Given the prevalence of preexisting coronary anomalies, patients with pulmonary atresia with intact ventricular septum were excluded. The Norwood procedure was the initial . . . [Full Text of this Article]




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