Dalby Stephen T, Fiedorek Daniel, Daily Joshua A
Arkansas Children'S Hospital, 1 Children's Way, Slot 512-3, Little Rock, AR, 72202, USA.
University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Pediatr Cardiol. 2025 Mar 22. doi: 10.1007/s00246-025-03837-1.
In infants with ductal dependent pulmonary blood flow (DDPBF), clinicians face a critical choice between two interventions to secure stable pulmonary circulation: the Blalock-Taussig-Thomas (BTT) shunt and patent ductus arteriosus (PDA) stenting. While the BTT shunt has long been the standard palliative procedure, its risks have prompted interest in less invasive alternatives. This manuscript explores the psychological and institutional factors contributing to the growing preference for PDA stenting over surgical shunting in the management of DDPBF. Cognitive biases, public reporting of surgical outcomes, and family preferences significantly influence clinicians' procedural decisions. Understanding these influences is essential to align clinical decisions with evidence-based practices, ensuring optimal care for patients while maintaining transparency and equity in procedural evaluation.
在患有导管依赖性肺血流（DDPBF）的婴儿中，临床医生在两种确保稳定肺循环的干预措施之间面临着关键选择：布莱洛克 - 陶西格 - 托马斯（BTT）分流术和动脉导管未闭（PDA）支架植入术。虽然BTT分流术长期以来一直是标准的姑息性手术，但其风险促使人们对侵入性较小的替代方法产生兴趣。本手稿探讨了在DDPBF管理中，导致越来越倾向于PDA支架植入术而非手术分流术的心理和制度因素。认知偏差、手术结果的公开报告以及家庭偏好显著影响临床医生的手术决策。了解这些影响对于使临床决策与循证实践保持一致至关重要，在确保为患者提供最佳护理的同时，在手术评估中保持透明度和公平性。
