Pediatric Sano shunt procedure

At The Heart Center at Children’s Health℠, our pediatric heart surgeons have extensive expertise in Sano shunt procedures. With years of advanced training and experience, our skilled surgeons consistently achieve higher success rates than the national average.

Dallas

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What is a pediatric Sano shunt procedure?

A Sano shunt is a small plastic tube that allows the heart to pump blood to the lungs to pick up oxygen. The shunt connects the right ventricle (pumping chamber) of a baby’s heart to the lung artery. Our heart surgeons place the shunt during a heart surgery called the Norwood procedure.

Babies born with a complex heart disease called hypoplastic left heart syndrome (HLHS) may need heart surgery to place a Sano shunt. For babies with HLHS, a Sano shunt helps their heart pump more oxygen-rich blood to the body.

Why does my child need the pediatric Sano shunt procedure?

Your baby may need a Sano shunt if they were born with HLHS, a type of single ventricle heart defect. With HLHS, the left side of a baby’s heart doesn’t fully develop before birth, so the right side must pump blood to the body. With only half their heart working, your baby’s body doesn’t receive enough blood and oxygen.

At The Heart Center, our pediatric heart surgeons specialize in advanced procedures to treat critical congenital heart diseases. Babies who have HLHS need a series of three complex surgeries to create a different way for their hearts to circulate blood. Newborns have the first surgery, the Norwood procedure, within their first two weeks of life.

During the Norwood procedure, our heart surgeons place either a Sano shunt or a Blalock-Taussig shunt. Surgeons choose the type of shunt depending on the details of your baby’s heart structure.

What are the benefits of the pediatric Sano shunt procedure?

The Sano shunt technique is part of the Norwood procedure, the first of three lifesaving surgeries for babies who have HLHS. The Sano shunt helps send more blood to the lungs to pick up oxygen. In turn, more oxygen reaches your baby’s body and organs, helping them grow and get stronger.

What are the risks with the pediatric Sano shunt procedure?

We provide the highest level of care for your baby to help minimize the risk of complications after surgery. Your child’s care team will explain the Sano shunt procedure and any potential risks.

Because the shunt is plastic, it will not grow, so as the baby grows it will eventually become too small. In addition, a blood clot or scar tissue may develop inside the shunt, causing a partial obstruction. With either issue, the baby will show lower blood oxygen levels and may require treatment with either:

Cardiac catheterization, a minimally invasive procedure that uses a catheter (thin tube) inserted through a tiny incision to access and treat the heart
Earlier performance of the next planned surgery, the Glenn procedure

What are Children’s Health’s outcome metrics for the pediatric Sano shunt procedure?

Our team has experienced 100% survival for children undergoing the Sano version of the Norwood procedure since 2020.

What to expect with the pediatric Sano shunt procedure?

Pediatric cardiologists in our Fetal Heart Program can often diagnose HLHS before your baby is born. Doctors may also diagnose the condition soon after birth.

After we confirm a diagnosis, we care for your newborn in our cardiac intensive care unit (CICU) before surgery. If your baby is born at another hospital, we work with your care team there to quickly bring your baby here. Our team explains HLHS and the surgical procedures, helping you understand the next steps for your child’s health.

What to expect before the pediatric Sano shunt procedure

Our pediatric CICU is the largest in North Texas, with an experienced team dedicated to the highest level of pediatric heart care. We monitor your baby around the clock, managing their condition before the Norwood procedure to place the Sano shunt.

Newborns have openings in their hearts that naturally close soon after birth. In babies with HLHS, this closure could be life-threatening, cutting off blood flow through the heart. We give your child intravenous (IV) medication to temporarily keep the holes open until it’s time for the shunt procedure.

What to expect during the pediatric Sano shunt procedure

The Norwood procedure is an open-heart surgery and takes about six to eight hours. During the overall surgery, the Sano shunt procedure takes about two hours. We connect your baby to a heart-lung bypass machine to circulate oxygen-rich blood during the surgery.

What to expect after the pediatric Sano shunt procedure

CICU and hospital stay - Your baby begins recovery in the CICU, receiving round-the-clock care for about two weeks after surgery. Your baby then moves to a regular hospital room for about three more weeks, a total of about five weeks in the hospital.

Newborns who receive a Sano shunt still have low oxygen in their blood, and their skin may have a bluish color. These symptoms will go away after the next two surgeries to improve their circulation.

The period after the Norwood and Sano shunt procedures and before the second surgery is a critical time for your baby’s health. Some babies may need to stay in the hospital until the second surgery, up to six months. Most babies can go home with the help of our Safe at Home Program.

Safe at Home is the only program in North Texas that helps parents care for their babies between heart surgeries for HLHS. Our experienced team provides education and 24/7 support to help you feel confident when you take your baby home. Every day, we monitor your baby’s health remotely so we can spot potential problems quickly.

What questions should I ask my provider about the pediatric Sano shunt procedure?

How many Sano shunt procedures have you performed?
How soon will I be able to see my child after surgery?
Will my child go home with any special equipment after receiving a Sano shunt?
What support services are available for families with a baby who has a congenital heart disease?

Frequently Asked Questions

What other procedures will my child need?
With HLHS, a Sano shunt procedure (during a Norwood procedure) is the first of three heart surgeries that your baby needs. The next two surgeries are the:
- Glenn procedure, when your baby is between three and six months old
- Fontan procedure, when your child weighs more than 25 pounds, typically between two and four years old
- Fontan revision
With these procedures, our surgeons rebuild your child’s heart to improve the way it circulates blood so their body gets enough oxygen. But even after these surgeries, your child will always have just one working pumping chamber in their heart.
How does a pediatric Sano shunt procedure affect my child’s development?

HLHS reduces the amount of oxygen in your baby’s blood, which can slow their growth and development. The Sano shunt – and the other surgeries – help your child’s heart pump better so their organs and body receive the oxygen they need for proper growth.

The three stages of surgery help your child live a full, active life. Your child’s cardiologist will advise you about physical activities that may be too strenuous, depending on your child’s overall health.
What kind of follow-up care will my child need?

After the three heart surgeries, your child needs lifelong care with a cardiologist. When they’re old enough, they can transition to our adult congenital heart disease program. A cardiologist provides specialized care to monitor your child for heart conditions or other possible complications. With regular visits, your child’s doctor can find potential problems and treat them early.