Growth of the Pulmonary Arteries Following Systemic-Pulmonary Shunt

Our study included 35 patients (26 of them were tetralogy of Fallot) with cyanotic congenital heart disease who underwent systemic-pulmonary shunt operation. Changes in size of pulmonary arteries were followed by echocardiography. "z" value, indicating the difference of the right (RPA) and left (LPA) pulmonary artery diameters of these patients from the mean of the normals children with the same body surface area in terms of the standard deviation and McGoon ratios before and after the operation were calculated. "z" value of RPA was found -1.12±1.09 after the procedure while it was -2.39±1.60 before the operation (p<0.0001). These values for LPA before and after the operation were -1.39±1.44 and -0.32±1.40 respectively (p<0.005). "z" value for the total diameters of RPA and LPA was -2.10±1.43 before the operation and it proved -0.86±1.13 after that (p<0.001). McGoon ratio was found to increase from 1.66±0.34 to 2.02±0.28 (p<0.001). There was no difference between the pulmonary artery growth of the patients operated before and after the age of 2 years. In conclusion, our results confirmed that systemic to pulmonary shunt operations affect the prowth of pulmonary arteries positively, in addition to their known effects on decreasing hypoxia in patients with cyanotic congenital heart disease with pulmonary stenosis.