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Palliation Techniques

  • Constantine Mavroudis
  • Joseph A. Dearani
Chapter

Abstract

Palliative surgical techniques for adults with congenital heart disease are more complex than techniques used for neonates, infants, and children. Surgical palliation in the young is performed with the idea that eventually there will be a “complete repair” as defined by complete separation of the pulmonary and systemic circulations. Pulmonary artery bands are placed to protect the pulmonary bed for a future operation or for left ventricular (LV) training in anticipation of an arterial switch operation. Systemic-to-pulmonary artery shunts are placed for cyanosis or as the sole source of pulmonary artery perfusion in anticipation of further reparative operations when anatomic and physiologic conditions are more favorable. Bidirectional Glenn shunts are placed as an interim physiologic operation en route to a Fontan operation or as an adjunct for patients with a small pulmonary ventricle resulting in a 1½ ventricular repair. So palliation is performed in most cases as preparation for another reparative operation.

Keywords

Palliative Adult congenital heart surgery Pulmonary artery band Modified Blalock-Taussig shunt Bidirectional Glenn shunt Fistula 

Abbreviations

Ao

Aorta

LV

Left ventricle

MPA

Main pulmonary artery

PA

Pulmonary artery

PAB

Pulmonary artery band

PTFE

Polytetrafluoroethylene

RA

Right atrium or right arch

RPA

Right pulmonary artery

RV

Right ventricle

RVOT

Right ventricle outflow tract

SCV

Superior caval vein

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Constantine Mavroudis
    • 1
  • Joseph A. Dearani
    • 2
  1. 1.Professor of SurgeryJohns Hopkins University School of Medicine, Johns Hopkins All Children’s HospitalSt. PetersburgUSA
  2. 2.Professor of Surgery, Department of Cardiac SurgeryMayo ClinicRochesterUSA

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