• MeSH
• Surgical Procedures, Operative MeSH
• Tissue and Organ Harvesting MeSH
• Organ Transplantation * MeSH
• Publication type
• Textbook MeSH

• Conspectus
• Patologie. Klinická medicína
• NML Fields
• transplantologie
• NML Publication type
• kolektivní monografie

• MeSH
• Child MeSH
• Immunization MeSH
• Immunosuppressive Agents MeSH
• Organ Transplantation MeSH
• Transplantation Immunology MeSH
• Check Tag
• Child MeSH

• Conspectus
• Pediatrie
• NML Fields
• pediatrie
• transplantologie

Right-sided BSCA provides for satisfactory pulmonary arterial growth in infants and children with complex congenital heart defects, and it could enhance the growth of a small right pulmonary artery. The growth of the left pulmonary artery, particularly in younger patients, needs close attention to confirm the safe role of BSCA in long-term palliation.

• MeSH
• Anastomosis, Surgical methods   MeSH
• Pulmonary Artery surgery   growth & development   MeSH
• Child MeSH
• Infant MeSH
• Humans MeSH
• Linear Models MeSH
• Infant, Newborn MeSH
• Palliative Care MeSH
• Child, Preschool MeSH
• Vena Cava, Superior surgery   MeSH
• Heart Defects, Congenital surgery   MeSH
• Check Tag
• Child MeSH
• Infant MeSH
• Humans MeSH
• Male MeSH
• Infant, Newborn MeSH
• Child, Preschool MeSH
• Female MeSH

BACKGROUND: It is common practice to interrupt all alternative sources of pulmonary blood flow ("competitive flow") at the time of a bidirectional superior cavopulmonary anastomosis (BCPA), although the merits of this have not been systematically studied. METHODS AND RESULTS: We reviewed the early and medium-term clinical and hemodynamic findings in 108 consecutive patients 3 weeks to 25 years old (median, 1.9 years) undergoing BCPA at one of three institutions. Preoperatively, pulmonary blood flow was dependent on antegrade ventricular flow (n = 50), systemic-to-pulmonary shunts (n = 33), or mixed sources (n = 25). Postoperatively, competitive sources of pulmonary blood flow were left patent in 43 of 108 patients (40%). There were four early (3.7%) and four late deaths, none related to persistence of competitive flow. After BCPA, patients with competitive flow had significantly higher systemic oxygen saturations at 1 hour (85% versus 79%), 24 hours (84% versus 78%), and at hospital discharge (84% versus 78%) and required a shorter period of artificial ventilation (median, 9 versus 24 hours) and intensive care (median, 2 versus 4 days). Oxygen saturations at late follow-up (median, 2.8 years; range, 1 to 7) did not differ (83% versus 82%). No patient developed pulmonary arteriovenous malformations. CONCLUSIONS: Competitive flow is well tolerated in the short and medium term after BCPA, and early postoperative systemic oxygen saturations are improved. The long-term influence of competitive flow on pulmonary arterial growth, arteriovenous malformation development, and ventricular function warrants investigation.

• MeSH
• Heart Bypass, Right methods   mortality   MeSH
• Child MeSH
• Adult MeSH
• Hemodynamics MeSH
• Infant MeSH
• Oxygen blood   MeSH
• Humans MeSH
• Adolescent MeSH
• Follow-Up Studies MeSH
• Infant, Newborn MeSH
• Palliative Care MeSH
• Pulmonary Circulation MeSH
• Postoperative Complications MeSH
• Postoperative Period MeSH
• Child, Preschool MeSH
• Retrospective Studies MeSH
• Aging physiology   MeSH
• Treatment Outcome MeSH
• Check Tag
• Child MeSH
• Adult MeSH
• Infant MeSH
• Humans MeSH
• Adolescent MeSH
• Male MeSH
• Infant, Newborn MeSH
• Child, Preschool MeSH
• Female MeSH