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Shunting Options Compared in Infant Heart Defect Procedure

Right ventricle-pulmonary artery shunt better than modified Blalock-Taussig shunt in short term only

WEDNESDAY, May 26 (HealthDay News) -- Use of a right ventricle-pulmonary artery (RVPA) shunt in infants undergoing the Norwood procedure results in better transplantation-free survival in the short term than use of a modified Blalock-Taussig (MBT) shunt, but the advantage fades in longer follow-up, according to a study in the May 27 issue of the New England Journal of Medicine.

Richard G. Ohye, M.D., of the University of Michigan Medical School in Ann Arbor, and colleagues randomized 549 infants with hypoplastic heart syndrome or related anomalies to undergo the Norwood procedure with either an MBT shunt or an RVPA shunt.

At 12 months, the researchers found that the incidence of nonfatal serious adverse events was similar in the two groups, but transplantation-free survival was higher in the infants receiving the RVPA shunt compared to the MBT shunt (74 and 64 percent, respectively). However, the RVPA group had more complications and unintended interventions than the MBT group. In follow-up for a mean 32 months, the difference in survival without transplantation between the two groups was not significant.

"In children undergoing the Norwood procedure, transplantation-free survival at 12 months was better with the RVPA shunt that with the MBT shunt. After 12 months, available data showed no significant difference in transplantation-free survival between the two groups," the authors write.

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