Kumar Shine, Kumar Raman Krishna
Department of Pediatric Cardiology, Amrita Hospital, Amrita Vishwa Vidyapeetham University, Kochi, 682041 Kerala India.
Indian J Thorac Cardiovasc Surg. 2025 Jun;41(6):718-729. doi: 10.1007/s12055-024-01786-7. Epub 2024 Aug 13.
Left to right shunts comprise a specific group of congenital heart disease, when identified and treated on time result in excellent outcomes. However, a proportion of these defects do not receive the timely intervention and often present late posing the question of safe operability especially in low- and middle-income countries. The lack of ample evidence and standardised guidelines often poses an enigma to the treating physician preventing appropriate and patient-friendly decision-making. Moreover, no single test or clinical feature can accurately define operability in this subset of patients. In this review, we aim to address this issue in a comprehensive and holistic manner and formulate a simplified guideline based on current evidence to help the physician to arrive at an appropriate decision.
ECG, electrocardiogram; L-R left to right.
左向右分流是先天性心脏病的一个特定类型，若能及时识别并治疗，预后良好。然而，这些缺陷中有一部分未得到及时干预，常常出现较晚，这就带来了安全可操作性的问题，尤其是在低收入和中等收入国家。缺乏充分的证据和标准化指南常常给治疗医生带来难题，阻碍做出恰当且对患者友好的决策。此外，没有单一的检查或临床特征能够准确界定这类患者的可操作性。在本综述中，我们旨在全面、整体地解决这一问题，并根据现有证据制定简化指南，以帮助医生做出恰当决策。
ECG，心电图；L-R，左向右。
