Off-pump Laks-type central shunt for tricuspid atresia with small branch pulmonary arteries.

Prostaglandin E1 is a potent vasodilator that prevents the ductus arteriosus from closing. Its use in neonates with cyanotic heart defects has revolutionized the management of children with cyanotic heart defects. Although the use of prostaglandin E1 is a temporary solution, the establishment of dependable pulmonary blood flow is of paramount importance. Several strategies with limitations are available (patent ductus arteriosus stenting, a central shunt, a Blalock-Thomas-Taussig shunt). We present a neonate with tricuspid atresia and tortoises restrictive patent ductus arteriosus on a high dose of prostaglandin E1 who underwent a Laks-type central shunt for branch pulmonary rehabilitation.