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Atrial septal defect with left-to-right shunt. The left and right sides of the heart are named from a dorsal view, i.e., looking at the heart from the back or from the perspective of the person whose heart it is. There are four chambers in a heart: an atrium (upper) and a ventricle (lower) on both the left and right sides. [1]
An uncorrected left-to-right shunt can progress to a right-to-left shunt; this process is termed Eisenmenger syndrome. [3] This is seen in Ventricular septal defect, Atrial septal defect, and patent ductus arteriosus, and can manifest as late as adult life. This switch in blood flow direction is precipitated by pulmonary hypertension due to ...
Eisenmenger syndrome is a reversal of the left-to-right heart shunt. This is the result of hypertrophy of the right ventricle over time. This causes a right-to-left heart shunt. The VSD allows deoxygenated blood to flow from the right to left side of the heart. This blood bypasses the lungs.
Aortopulmonary window (APW) is a faulty connection between the aorta and the main pulmonary artery that results in a significant left-to-right shunt. [2] The aortopulmonary window is the rarest of septal defects, accounting for 0.15-0.6% of all congenital heart malformations. [4]
The incidence of univentricular heart malformations is estimated at 0.1 to 0.4 per 1,000 live births. [3] In the neonatal period, these patients depend on an aortopulmonary shunt that is maintained medically with prostaglandin and then surgically with an initial cardiac shunt procedure.
Treatment is surgical and involves closure of the atrial and ventricular septal defects and restoration of a competent left AV valve as far as is possible. Open surgical procedures require a heart-lung machine and are done with a median sternotomy. Surgical mortality for uncomplicated ostium primum defects in experienced centers is 2%; for ...
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A Sano shunt is a shunt from the right ventricle to the pulmonary circulation. [1] [2] [3] In contrast to a Blalock–Taussig shunt, circulation is primarily in systole. [citation needed] It is sometimes used as the first step in a Norwood procedure. [citation needed] This procedure was pioneered by the Japanese cardiothoracic surgeon Shunji ...