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Shunt Lesions Part I: Patent Ductus Arteriosus, Atrial Septal Defect, Ventricular Septal Defect, and Atrioventricular Septal Defect

Backer, Carl L. MD1,2; Eltayeb, Osama MD1,2; Mongé, Michael C. MD1,2; Mazwi, Mjaye L. MD3,4; Costello, John M. MD, MPH3,4

Pediatric Critical Care Medicine: August 2016 - Volume 17 - Issue 8 - p S302-S309
doi: 10.1097/PCC.0000000000000786
Congenital Heart Disease
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Objectives: This review summarizes the current understanding of the pathophysiology and perioperative management of patent ductus arteriosus, atrial septal defect, ventricular septal defect, and atrioventricular septal defect.

Data Source: MEDLINE and PubMed.

Conclusions: The four congenital cardiac lesions that are the subject of this review, patent ductus arteriosus, atrial septal defect, ventricular septal defect, and atrioventricular septal defect, are the most commonly found defects causing a left-to-right shunt. These defects frequently warrant transcatheter or surgical intervention. Although the perioperative care is relatively straightforward for many of these patients, there are a number of management strategies and complications associated with each intervention. The treatment outcomes for all of these lesions are very good in the current era.

1Division of Cardiovascular-Thoracic Surgery, Ann & Robert H. Lurie Children’s Hospital, Chicago, IL.

2Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL.

3Division of Cardiology, Ann & Robert H. Lurie Children’s Hospital, Chicago, IL.

4Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL.

Dr. Costello’s efforts were supported in part by an endowment established for the Division of Cardiology at Ann & Robert H. Lurie Children’s Hospital of Chicago by Mr. Warren Batts. Dr. Mazwi’s contributions are supported in part by the Ginsburg family. Dr. Costello is employed by Ann & Robert H. Lurie Children’s Hospital and provided expert testimony for White& Williams, LLP. The remaining authors have disclosed that they do not have any potential conflicts of interest.

For information regarding this article, E-mail: jmcostello@luriechildrens.org

Copyright © 2016 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies