Open Access

ARTICLE

Risk Factor Analysis for Shunt Failure after Systemic Pulmonary Shunt

by Han Zhang, Gang Li, Xiangming Fan, Junwu Su^*

Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China

* Corresponding Author: Junwu Su. Email:

Congenital Heart Disease 2020, 15(5), 361-367. https://doi.org/10.32604/CHD.2020.013020

Received 22 July 2020; Accepted 18 August 2020; Issue published 23 September 2020

Abstract

Background: To identify factors associated with shunt failure in patients with a systemic pulmonary shunt (SPS). Methods: We retrospectively assessed 451 patients who received SPS. Perioperative parameters such as hemoglobin, Nakata Index, and shunt size were assessed, and factors influencing shunt failure after an initial palliative shunt operation were analyzed. Results: We analyzed 451 patients who underwent isolated SPS surgery at Anzhen Hospital. Of these, shunt failure occurred in 48 (10.6%) cases after a median of 6.5 days. The 30-day mortality rate was 2.1%. Univariate and logistic regression analysis revealed that a Nakata Index ≤ 105 and vasoactive-inotropic score (VIS) ≥ 8.5 were risk factors for shunt failure. Conclusion: Nakata Index ≤ 105 was identified as a risk factor for shunt failure. A maximum VIS of ≥8.5 over the first 24 h was a good predictor of poor clinical outcomes. After SPS, close monitoring of the balance of systemic and pulmonary circulation, usage of appropriate vasoactive-inotropic agents, and early intervention could reduce the occurrences of shunt failure.

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