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Nancy S. Ghanayem, MD, Robert D. B. Jaquiss, MD, Joseph R

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1 Right Ventricle–to–Pulmonary Artery Conduit Versus Blalock-Taussig Shunt: A Hemodynamic Comparison 
Nancy S. Ghanayem, MD, Robert D.B. Jaquiss, MD, Joseph R. Cava, MD, Peter C. Frommelt, MD, Kathleen A. Mussatto, RN, George M. Hoffman, MD, James S. Tweddell, MD  The Annals of Thoracic Surgery  Volume 82, Issue 5, Pages (November 2006) DOI: /j.athoracsur Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions

2 Fig 1 Arterial (AP) and central venous (CVP) pressures are shown as mean ± standard deviation in mm Hg between groups. The Blalock-Taussig (BT) shunt group is on the left panel and the right ventricle-to-pulmonary artery (RV-PA) conduit group is on the right panel. Systolic (gray line with circles), mean arterial (black line with circles), and central venous pressures (black line with ovals) were similar between groups. Diastolic blood pressure was lower in the BT shunt group compared with the RV-PA conduit group (39 ± 4 versus 46 ± 6 mm Hg, p < 0.001). The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions

3 Fig 2 Arterial saturation (SaO2, solid line), superior vena cava venous oximetry (SvO2, gray line), and near infrared spectroscopy cerebral (dashed black line) and somatic oxyhemoglobin saturations (rSO2, dashed gray line) displayed in 4-hour intervals over the first 48 hours in the Blalock-Taussig (BT) shunt and right ventricle–to–pulmonary artery (RV-PA) conduit groups. Each point represents the group 4-hour mean and 95% confidence interval. There was no significant difference in mean values or in variation of parameters between groups. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions

4 Fig 3 Pulmonary blood flow (Qp), systemic blood flow (Qs), and pulmonary/systemic blood flow ratio (Qp/Qs) displayed in 4-hour intervals over the first 48 hours in the Blalock-Taussig (BT) shunt and right ventricle–to–pulmonary artery (RV-PA) conduit groups. Each point represents the group 4-hour mean, and the 95% confidence interval is displayed for each point. Although the 48 hour means are not different, the variability was greater in the RV-PA conduit group for Qs (p < 0.01 by the Levene test) and Qp/Qs (p < 0.001). The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions

5 Fig 4 The relationship between mean arterial blood pressure (MABP) and arterial saturation (SaO2), superior vena cava venous oximetry (SvO2,) (solid lines), and pulmonary blood flow (Qp), and systemic blood flow (Qs) (dashed line) is shown by fractional polynomial modeling in the modified Blalock-Taussig (BT) shunt and right ventricle–to–pulmonary artery (RV-PA) conduit groups. Qp was higher and more variable at MABP greater than 50 mm Hg in the RV-PA conduit group (p < 0.05 by fractional polynomial regression and analysis of variance). Data are shown as mean ± standard deviation (gray shaded area). The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions


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