To evaulate the effectiveness and risk factors for shunt failure of the Blalock-Taussig shunt in neonates, we analyzed the 21 neonates who were undergone Blalok-Taussig shunt operation at Dong-A University Hospital from December 1991 to Feburary 1996. We evaluated operative mortality, patency of the shunt. and distortion of pulmonary artery. We also determined the risk factors for the shunt failure. Age at operation was from 1 day to 30 days(mean 11.7 days). Weights were 2.4 to 4.5kg(mean 3.1 kg). The underlying lesions included severe tetralogy of Fallot with pulmonary stenosls or atresia(N=11) and single ventricle varieties with. pulmonary stenosis or atresia(N=10). Prostaglandin E1 was given in 13 neonates prior to operation. The mean preoperative(prior to prostaglandin El therapy) and postoperative arterial oxygen tension were 30.1 mmHg and 46.3 mmHg respectively(P<0.01). The shunt was performed through a left thoracotomy in 11 patients and through a right thoracotomy In 10. A 5 mm graft was used in 15 patients and a 4 mm graft in 6 patients. The incidence of early shunt occlusion was 9.5%(2 patients). The hospital mortality was 9.5%(2 patients with early shunt occlusion). Univariate analysis revealed that body weight of 2.6 kg or less(p=0.021), pulmonary artery size of 3mm or less(p=0.008), and 4 mm graft (p=0.021) were risk factors predictive of early shunt failure. The patency rate of the shunt in hospital survivors was 100% at mean ollow-up of ll.3 months(There was not death or reoperation related to shunt failure). 10 patients were catheterized during postoperative follow-up. There was no significant distorsion of pulmonary artery. So we concluded that the modified Blalock-Taussig shunt in neonates was excellent in the hospital survivors.
Alprostadil ; Blalock-Taussig Procedure* ; Body Weight ; Catheters ; Follow-Up Studies ; Hospital Mortality ; Humans ; Incidence ; Infant, Newborn* ; Mortality ; Oxygen ; Pulmonary Artery ; Pulmonary Valve Stenosis ; Reoperation ; Risk Factors ; Survivors ; Tetralogy of Fallot ; Thoracotomy ; Transplants ; Weights and Measures

No abstract available.
Histiocytoma, Benign Fibrous* ; Pulmonary Sclerosing Hemangioma*

No abstract available.
Bronchi* ; Bronchogenic Cyst* ; Trachea*

No abstract available.
Constriction, Pathologic*

No abstract available.
Dilatation, Pathologic*

No abstract available.
Aortic Aneurysm, Abdominal* ; Pulmonary Embolism* ; Venous Thrombosis*

No abstract available.
Pneumonectomy*

No abstract available.
Fistula*

BACKGROUND: Surgical correction of the full spectrum of esophageal atresia with tracheoesophageal fistula has improved over the years, but the mortality and morbidity assoiated with repair of these anomalies still remains high. MATERIAL AND METHOD: We retrospectively analyzes 27 surgically treated patients with esophageal atresia and tracheoesophageal fistula at Dong-A University Hospital between January 1992 and March 1997. RESULT: There were 21 male and 6 female patients. Mean birth weight was 2.62+/-.385 kg(2.0~3.4 kg). Twenty- four(88.9%) had esophageal atresia with distal tracheoesophageal fistula, and 3(11.1%) had pure esophageal atresia. Four(14.8%) infants were allocated to Waterston risk group A, 18(66.7%) to group B, and 5(18.5%) to group C. In eighteen(66.7%) infants with associated anomalies, cardiovascular anomalies were the most common. Three had a gap length of 3.5 cm or greater(ultra-long gap) between esophageal segments, 7 had 2.0 to 3.5 cm(long gap), 8 had 1.0 to 2.0 cm(medium gap), and 9 had 1 cm or less(short gap) gap length. Among 27 neonates, 3 cases underwent staged operation, late colon interposition was done in 2, and all other 24 cases underwent primary esophageal anastomosis. Oerative mortality was 2/27(7.4%). Causes of death included acute renal failure(n=1), empyema from anastomotic leak(n=1), necrotizing enterocolitis(n=1), sepsis(n=1), insulin-dependent diabetus mellitus(n=1 . There were 4 anastomosis- related complications including stricture in 3, leakage in 1. Mortality was related to the gap length(p<.05). CONCLUSION: Although the complication rate associated with surgical repair of these anomalies is high, this does not always implicate the operative mortality. The overall survival can be improved by effective treatment for combined anomalies and intensive postoperatve care.
Birth Weight ; Cause of Death ; Colon ; Constriction, Pathologic ; Empyema ; Esophageal Atresia* ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Mortality ; Retrospective Studies ; Tracheoesophageal Fistula

Acquired pulmonary artery stenosis which is secondary to tuberculosis is so rare that only a few scattered cases have been reported. We report one case of pulmonary stenosis caused by pulmonary tuberculosis.l A 50 year old man who gradually developed dyspnea was diagnosed as bilateral pulmonary stenosis, he underwent bypass surgery between the main diagnosed as bilateral pulmonary stenosis. he underwent bypass surgery between the main pulmonary artery and the right pulomonary artery with a 13mm Gortex ringed straight graft. The left pulmonary artery was too small to restore the perfusion. The patient was discharged on the 33rd day after the operation. Acquired pulmonary stenosis could be treated successfully with one-side pulmonary arery reconstruction.
Arteries ; Constriction, Pathologic ; Dyspnea ; Humans ; Middle Aged ; Perfusion ; Pulmonary Artery ; Pulmonary Valve Stenosis* ; Transplants ; Tuberculosis* ; Tuberculosis, Pulmonary