Development of pulmonary arteriovenous shunt after superior vena cava right pulmonary artery (Glenn) anastomosis. Report of 4 cases

Four patients with cyanotic congenital heart disease who had previously undergone superior vena cava right pulmonary artery (Glenn) anastomosis developed pulmonary arteriovenous malformations that resulted in significant intrapulmonary right to left shunting. This abnormality was documented by selective angiography, oximetry, and contrast echocardiography. It may be a major cause of late clinical deterioration in patients treated with the Glenn anastomosis.