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 func tion and patency of Gore-Tex shunts, angiographic features of 62 Gore- Tex shunts were assessed, 31 without and 31 with postoperative ASA. Gr oups were selected on the basis of similar angiographic follow-up dura tion. Mean follow-up was 709 days for the group without ASA and 739 da ys 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 w as 581 days in the group without ASA (operated between 1983 and 1987) and 303 days in the group with (operated between 1987 and 1991), refle cting the fact that patients were operated upon earlier after 1987. Pr eoperative Gore-Tex diameter was similar between the two groups, but t hree patients in the group with ASA had a Gore-Tex shunt as small as 4 mm. At angiography, four conduits were diagnosed as nonpatent (two in each group), 20 had a localized stenosis (11 of 28 in the group witho ut ASA and nine of 23 in the group with ASA). Patency index (angiograp hic Gore-Tex diameter/preoperative Gore-Tex diameter) was similar in t he two groups: 68.5% in the group without ASA and 69.7% in the group w ith ASA. Pulmonary artery growth index was 57% in the group without AS A and 91% in the group with ASA. No risk factor for thrombosis or decr eased patency was found. In conclusion, ASA does not seem to improve p atency of Gore-Tex shunts at two years and should not be administered routinely in this setting. Nevertheless, prospective studies should be conducted to investigate a functional improvement of Gore-Tex shunts.