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A pulmonary shunt is the passage of deoxygenated blood from the right side of the heart to the left without participation in gas exchange in the pulmonary capillaries. It is a pathological condition that results when the alveoli of parts of the lungs are perfused with blood as normal, but ventilation (the supply of air) fails to supply the perfused region.
Although the mechanism is still unclear, it is thought to be caused by right to left shunting of blood flow due to an anatomic defect allowing communication between right and left-sided circulation, such as an atrial septal defect, patent foramen ovale, or pulmonary atrioventricular malformations, and a functional component that causes blood to ...
In patients with pulmonary atresia, there is complete failure of forward flow from the right ventricle to the pulmonary arterial vasculature. As such, pulmonary blood flow is entirely dependent on shunting from the systemic circulation, typically through a patent ductus arteriosus.
Heart Failure: The single ventricle must support both systemic and pulmonary circulation, which can lead to heart failure if demands exceed functional capacity. [ 30 ] Arrhythmias: Abnormal heart rhythms can occur due to the congenital defect or secondary to manipulation of cardiac tissue during surgery.
If right ventricular failure develops, right atrial pressure will increase, and this may result in a persistent opening of the foramen ovale, shunting of unoxygenated blood from the right atrium into the left atrium, and systemic cyanosis. If pulmonary stenosis is severe, congestive heart failure occurs, and systemic venous engorgement will be ...
The mechanism of many of the risks and complications related to failure of the Glenn bidirectional shunt is thought to be thrombosis. Right-side dominant circulation, elevated pulmonary vascular resistance, and prolonged operative and recovery time are the major factors that increase the risk of complications and failure.
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