SYSTEMIC

PULMONARY FISTULA
ERIKA LIZETH CARREÑO CONTRERAS

 PATIENT INFORMATION

Name: AD
ID: 672383
TYPE OF BLOOD: A+
EPS: Sanitas
AGE: 2 Year

 DEFINITION

Anastomoses between the systemic and pulmonary

circulation can be of congenital or acquired origin.
Approximately 15% of systemic-pulmonary fistulas (SPF) are
congenital, and are associated with heart disease or
pulmonary artery hypoplasia1. Acquired PSFs, which are
the most common, can be due to inflammatory, infectious,
traumatic, surgical, or neoplastic causes, among others.


1. High early permeability.
2. Regulation of the shunt by the
size of the systemic artery.
3. Preservation of the subclavian
artery.
4. Relative ease of the surgical
procedure
rigid material anastomosed to
1. PTFE graft is not an optimal
material, its low late patency rate
may be due to excessive
pseudointima formation, especially
in 3 and 3.5 mm grafts, and
2. The high incidence of pulmonary
artery distortion that can
be due, in part, to the use of thick,
small or thin arteries
 SURGICAL TECHNIQUE
The modified Blalock-Taussig fistula, by posterolateral thoracotomy
at the level of the third intercostal space, dissection is made
proximal to the subclavian artery, and then to the homolateral
pulmonary branch. Next, clamping and arteriotomy of the
subclavian artery and end-to-side anastomosis of a 3.5 or 4 mm
PTFE tube with continuous polypropylene suture are performed.
8/0; The anastomosis of the distal end of the fistula to the branch
of the pulmonary artery is done in a similar way to the previous
one and then the clamps of the pulmonary and subclavian arteries
are removed, respectively.
 BIBLIOGRAPHY

https://es.slideshare.net/PONIENT
https://www.revista-portalesmedicos.com/revista-medica/-tipos-indicaciones-y-
procedimiento/
https://rushmedical.com.ec/producto/cotonoides/