{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T08:55:00Z","timestamp":1790758500794,"version":"4.1.0"},"reference-count":0,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thorac cardiovasc Surg"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:p>\n            Background\u2003Systemic-to-pulmonary artery shunt placement is an established palliative procedure for congenital heart disease. Although it is thought to be a simple operation, it is associated with significant morbidity and mortality.<\/jats:p><jats:p>\n            Methods\u2003Data for all neonates who underwent surgery for a systemic-to-pulmonary artery shunt between 2000 and 2016 were reviewed. The study endpoints were shunt failure and shunt-related mortality. Shunt failure was defined as a shunt dysfunction because of thrombosis or stenosis requiring intervention or reoperation; shunt mortality was defined as death because of a shunt dysfunction.<\/jats:p><jats:p>\n            Results\u2003A total of 305 shunts (central shunt, n\u2009=\u2009135; Blalock\u2013Taussig shunt, n\u2009=\u2009170) were implanted in 280 patients. The median patients' age at the time of surgery was 9 days (1\u201331 days). The median shunt size was 3.5\u2009mm (3\u20134 mm). Twenty-four patients (8%) were diagnosed with a shunt failure, with a median time of 7 days (0\u2013438 days). Freedom from shunt failure at 1\u2009year was 91.6%\u2009\u00b1\u20092%. A shunt-related mortality was ascertained for 12 patients (4%). Freedom from shunt-related mortality at 1\u2009year was 96%\u2009\u00b1\u20091%. Perioperative platelet transfusion (p\u2009=\u20090.01), central shunt (p\u2009=\u20090.02), 3-mm shunt size (p\u2009=\u20090.02), and postoperative extra corporeal membrane oxygenation (ECMO) (p\u2009&lt;\u20090.01) were identified as risk factors for shunt failure. Platelet transfusion (p\u2009=\u20090.04) and postoperative ECMO (p\u2009&lt;\u20090.01) were further identified as risk factors for shunt mortality.<\/jats:p><jats:p>\n            Conclusion\u2003Based on these data, we recommend implanting a modified Blalock\u2013Taussig shunt of at least 3.5\u2009mm in neonates. Perioperative platelet transfusion and postoperative ECMO increase the risk of shunt failure.<\/jats:p>","DOI":"10.1055\/s-0037-1621706","type":"journal-article","created":{"date-parts":[[2018,1,19]],"date-time":"2018-01-19T23:46:46Z","timestamp":1516405606000},"page":"002-007","source":"Crossref","is-referenced-by-count":13,"title":["Reasons for Failure of Systemic-to-Pulmonary Artery Shunts in Neonates"],"prefix":"10.1055","volume":"67","author":[{"given":"Cornelius","family":"Leopold","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Surgery, German Heart Centre Munich, Technische Universit\u00e4t M\u00fcnchen, Munich, Germany"},{"name":"Insure (Institute for Translational Cardiac Surgery), Department of Cardiovascular Surgery, German Heart Centre Munich, Technische Universit\u00e4t M\u00fcnchen, Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jelena","family":"von Ohain","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Surgery, German Heart Centre Munich, Technische Universit\u00e4t M\u00fcnchen, Munich, Germany"},{"name":"Insure (Institute for Translational Cardiac Surgery), Department of Cardiovascular Surgery, German Heart Centre Munich, Technische Universit\u00e4t M\u00fcnchen, Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cordula","family":"Wolf","sequence":"first","affiliation":[{"name":"Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Centre Munich, Technische Universit\u00e4t M\u00fcnchen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth","family":"Beran","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Surgery, German Heart Centre Munich, Technische Universit\u00e4t M\u00fcnchen, Munich, Germany"},{"name":"Insure (Institute for Translational Cardiac Surgery), Department of Cardiovascular Surgery, German Heart Centre Munich, Technische Universit\u00e4t M\u00fcnchen, Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R\u00fcdiger","family":"Lange","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Surgery, German Heart Centre Munich, Technische Universit\u00e4t M\u00fcnchen, Munich, Germany"},{"name":"Insure (Institute for Translational Cardiac Surgery), Department of Cardiovascular Surgery, German Heart Centre Munich, Technische Universit\u00e4t M\u00fcnchen, Munich Germany"},{"name":"German Heart Center Munich - DZHK Partner Site Munich Heart Alliance, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Cleuziou","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Surgery, German Heart Centre Munich, Technische Universit\u00e4t M\u00fcnchen, Munich, Germany"},{"name":"Insure (Institute for Translational Cardiac Surgery), Department of Cardiovascular Surgery, German Heart Centre Munich, Technische Universit\u00e4t M\u00fcnchen, Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keti","family":"Vitanova","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, German Heart Centre Munich, Technische Universit\u00e4t M\u00fcnchen, Munich, Germany"},{"name":"Insure (Institute for Translational Cardiac Surgery), Department of Cardiovascular Surgery, German Heart Centre Munich, Technische Universit\u00e4t M\u00fcnchen, Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2018,1,19]]},"container-title":["The Thoracic and Cardiovascular Surgeon"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0037-1621706.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,1,18]],"date-time":"2019-01-18T09:55:26Z","timestamp":1547805326000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0037-1621706"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,1,19]]},"references-count":0,"journal-issue":{"issue":"01","published-online":{"date-parts":[[2019,1,11]]},"published-print":{"date-parts":[[2019,1]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0037-1621706","relation":{},"ISSN":["0171-6425","1439-1902"],"issn-type":[{"value":"0171-6425","type":"print"},{"value":"1439-1902","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,1,19]]}}}