NEW YORK - Systemic-Pulmonary Arterial (SPA) is a procedure employed in newborns whose hearts have limited pulmonary arterial blood flow, usually because of an obstruction in the outflow. The SPA shunt is a common and important part of the surgical armamentarium for managing newborns to control the blood flow in their hearts. In a related article, expert David Greg and colleagues wrote that “there are three most common shunts used: the Waterston procedure, which connects the ascending aorta to the right pulmonary artery; the Potts procedure, which connects the descending aorta to the left pulmonary artery; and the Blalock-Taussig shunt, which connects the subclavian artery directly (classic) or indirectly via a Gore-Tex graft (modified) to the pulmonary artery.”¹

To improve the quality of care for neonates with heart defects, the study of the association between the risk factors (also known as predictors or features) and the outcomes has been the focus of many retrospective single, multi-institutional and registry-based retrospective studies. By determining the impact of a pre-selected risk factor (based on clinical judgment or prior empirical observations) from a given number of patient samples, it becomes possible to know the probability of the outcome for a patient who has a combination of the risk factors. To some extent, a certain amount of bias is entered in the selection and testing of these factors or variables, while at other t