Single ventricle and pulmonary stenosis. Surgical management in a patient over a period of 25 years

One of the longest living survivors of the Blalock-Taussig shunt is a patient with a complex form of cyanotic congenital heart disease, including a single ventricle (anatomically right), d-loop, anterior aorta, pulmonary valvular and subvalvular stenosis and anomalous pulmonary venous return to a common atrial chamber. A Blalock shunt was performed at age 21 months, a Potts anastomosis at age 9 years, and an 8 mm Dacron shunt was added between the ascending aorta and the pulmonary artery at age 24 years. The patient's arterial oxygen saturation level of 86 percent and his relative well-being and active life at age 26 years suggest that sequential aortopulmonary shunting with increasing age is desirable in some patients with complicated heart disease and severe polycythemia.