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Hsia TY et al. – Adding a mBT shunt to remedy a stenotic RV–PA shunt early after a Norwood operation can lead to pulmonary overcirculation and may decrease systemic oxygen delivery. The stenotic RV–PA shunt should be taken down. Conversion to an optimal mBT shunt is preferable to augmenting a stenotic RV–PA shunt with a smaller mBT shunt.

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