Pulmonary-to-systemic blood flow ratio oriented management after repair of obstructive total anomalous pulmonary venous connection in neonates with single ventricle.

Caval oxygen saturation was monitored to estimate pulmonary-to-systemic blood flow ratio after relief of obstructive total anomalous pulmonary venous connection in two neonates with single ventricle. Distribution between systemic and pulmonary blood flow was manipulated by pharmacologic, ventilatory, and surgical interventions aimed at achieving pulmonary-to-systemic blood flow ratio of 0.5 to 1.0. Monitoring of pulmonary-to-systemic blood flow ratio facilitates appropriate balancing between tissue perfusion and oxygenation, and detects redundant ventricular volume-load.