@Article{CHD.2020.013020,
AUTHOR = {Han Zhang, Gang Li, Xiangming Fan, Junwu Su},
TITLE = {Risk Factor Analysis for Shunt Failure after Systemic Pulmonary Shunt},
JOURNAL = {Structural and Congenital Heart Disease},
VOLUME = {15},
YEAR = {2020},
NUMBER = {5},
PAGES = {361--367},
URL = {http://www.techscience.com/schd/v15n5/40256},
ISSN = {3071-1738},
ABSTRACT = {<b>Background:</b> To identify factors associated with shunt failure in
patients with a systemic pulmonary shunt (SPS). <b>Methods:</b> 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. <b>Results:</b> 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. <b>Conclusion:</b> 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.},
DOI = {10.32604/CHD.2020.013020}
}