Introduction
Infants with congenital heart disease (CHD) and left-to-right shunts usually suffer from tachypnea, dyspnea, and recurrent pulmonary infections. Abnormal lung mechanics leading to increased work of breathing (WOB) have been suggested as a cause contributing to these findings (1). Although some studies observed no changes in lung mechanics (2), most studies documented decreased lung compliance in children and adults with significant CHD, pulmonary hypertension, and left-to-right shunts (3-11). The mechanisms causing this decrease in lung compliance have not been clarified. Some studies attributed this change to increased pulmonary blood flow (PBF)(8) or pulmonary hypertension, (5,7,9) while others found a decrease in both PBF and pulmonary arterial pressure (PAP)(3,4). There were also reports that found no correlation between reduced lung compliance and elevated PBF, PAP or pulmonary vascular resistance (6,10,11). ....

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