Use of acetylsalicylic acid to improve patency of subclavian to pulmonary artery Gore-Tex shunts.

In order to assess the influence of acetylsalicylic acid (ASA) on function and patency of Gore-Tex shunts, angiographic features of 62 Gore-Tex shunts were assessed, 31 without and 31 with postoperative ASA. Groups were selected on the basis of similar angiographic follow-up duration. Mean follow-up was 709 days for the group without ASA and 739 days for the group with it. The average daily dose of ASA was 4.5 mg/kg/day started a mean of 6.7 days after surgery. Clinical characteristics were similar between the two groups except for age at surgery which was 581 days in the group without ASA (operated between 1983 and 1987) and 303 days in the group with (operated between 1987 and 1991), reflecting the fact that patients were operated upon earlier after 1987. Preoperative Gore-Tex diameter was similar between the two groups, but three patients in the group with ASA had a Gore-Tex shunt as small as 4 mm. At angiography, four conduits were diagnosed as nonpatient (two in each group), 20 had a localized stenosis (11 of 28 in the group without ASA and nine of 23 in the group with ASA). Patency index (angiographic Gore-Tex diameter/preoperative Gore-Tex diameter) was similar in the two groups: 68.5% in the group without ASA and 69.7% in the group with ASA. Pulmonary artery growth index was 57% in the group without ASA and 91% in the group with ASA. No risk factor for thrombosis or decreased patency was found.(ABSTRACT TRUNCATED AT 250 WORDS)