Ascending aorta-right pulmonary artery shunt.

Seventy-seven patients with ascending aorta-right pulmonary artery shunt were reviewed; 48 had tetralogy of Fallot, 9 had pulmonary atresia, 11 had transposition of the great vessels with pulmonary stenosis, 4 had tricuspid atresia, and 5 had miscellaneous complex lesions. Their ages ranged from one day to 13 years. The over-all mortality rate was 17.8 per cent. Ten patients underwent total repair and takedown of the shunt with no deaths. The problems of increased pulmonary flow, pulmonary hypertension, preferential flow to one lung, kinking and distortion of the pulmonary artery, and the technical difficulties at the time of takedown were reviewed and discussed.