Cyanotic Rightto Left Shunt Lesions

Although cyanotic lesions, also known as right-to-left shunt lesions, are less common than their left-to-right counterparts, they are more complex, severe, and disabling for patients. The shunting of blood from the right to the left side of the heart reduces blood to the lungs, preventing proper oxygenation. This lack of oxygenation can lead to cyanosis, a blue coloration of the lips and fingernails. Cya-notic lesions include tetralogy of Fallot, transposition of the great arteries, pulmonary atresia, persistent truncus arteriosus, total anomalous pulmonary venous return, tricuspid atresia, Ebstein's anomaly, single ventricle physiology, and double outlet right ventricle. These defects require surgical correction at or near birth. Although surgical advances have greatly increased survivability and quality of life for affected youngsters, some of these patients do not survive beyond infancy and others suffer from limited physical abilities and shortened life span (De-Maso 2004). Together, these lesions account for 15%-28% of childhood heart defects, with tetralogy of Fallot being the most common at 5%-7% (Bernstein 2000).

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