Diagnosis and surgical treatment of five cases of triple shunt (ASD + VSD + PDA).

Five patients with triple shunt (atrial septal defect, ventricular septal defect, and patent ductus arteriosus) were treated surgically during the past twelve years (1978-1989). They developed severe cardiac and respiratory failure in the neonatal period and/or in early infancy. Simultaneous repair of the triple shunt was performed, but initially two patients suffering severe cardiac failure were lost immediately after operation. The following three patients were operated on relatively soon after establishing a definitive diagnosis and a successful outcome was able to be achieved. Repeated evaluation of the patient with echocardiography was necessary for diagnosis. Early primary operation is, therefore, considered to be the treatment of choice after confirming the diagnosis.