J Thorac Cardiovasc Surg 1995;109:817-818
© 1995 Mosby, Inc.
Bidirectional inferior vena cava-pulmonary artery shunt
Gaetano Azzolina, MD
Clinica Athena
San Remo, Italy
To the Editor:
In the May 1994 issue of this JOURNAL (1994;107:1367) I read a letter to the Editor written by Luisi, Murzi, Bernabei, Vanini, and Biagini concerning bidirectional inferior vena cava-pulmonary artery shunt. The authors claim to have performed the first bidirectional cavopulmonary shunt in 1972.
In the interest of ethics and accuracy, I must dispute their claim. I devised and first performed the procedure in 1968, and subsequently I published the first results in Thorax (1972;27:111-5).
I appreciate the increased consideration given to bidirectional cavopulmonary shunt in the recent years. Many patients on whom I operated in that initial period are still alive and doing satisfactorily with only that procedure. Therefore I believe that, in many cases, a mild cyanosis, absence of right heart failure, and a single operation are preferable to multiple procedures, often accompanied by untreatable right heart failure, hepatomegaly, and ascites.
