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Alerts clinicians to monitor shunt lesions for reversal risk; leaves open targeted prevention trials in congenital PH.
An important group of congenital cardiovascular defects is that characterized by the presence of an arterio-venous shunt, of which atrial septal defect, ventricular septal defect, and patent ductus arteriosus are common examples. In these the flow of blood is generally directed from left to right so that cyanosis is absent, but some may ultimately develop cyanosis (cyanose tardive) following a reversal of the shunt. Cardiac catheterization may then show the pressure in the pulmonary artery to be raised to the same level as that in the aorta.
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Evans et al. (1958) studied this question.
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