Univentricular heart palliation with clipped right ventricle-to-pulmonary artery shunt at 1.6 kg: A case report

A female infant with low body weight was diagnosed with double outlet right ventricle, pulmonary atresia, hypoplastic left ventricle, and patent ductus arteriosus. We performed a right ventricle-to-pulmonary artery shunt with a ringed expanded polytetrafluoroethylene graft (5 mm) using the Dunk technique at the age of 39 days (1622 g). The shunt was clipped to regulate the pulmonary blood flow. The clips were dislodged using balloon angioplasty 4 months postoperatively. Afterward, the patient underwent a Fontan procedure without fenestration during the third operation at the age of 3 years. She did not require pulmonary artery plasty or balloon angioplasty for the pulmonary artery during her course.