Disadvantages: Thrombosis of the shunt due to its size Subclavian or the innominate artery have to be sacrificed although it did not appear to have a clearly significant clinical effect[ 10 ] Extensive dissection[ 10 ] Significant arm ischemia from subclavian artery division was uncommon, although the pulse in the ipsilateral arm was often not felt for days after the operation Neurologic disadvantages are rare and include risk of recurrent laryngeal nerve injury, phrenic nerve injury, and Horner syndrome Various modifications of systemic-to-pulmonary artery shunt have been described.
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