Modified Blalock-Taussig shunts: Results in infants less than 3 months of age

• Published in: The Annals of thoracic surgery Vol. 49; no. 5; pp. 797 - 801
• Main Authors: Tamisier, Daniel, Vouhé, Pascal R., Vernant, Françoise, Leca, Francine, Massot, Christian, Neveux, Jean-Yves
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.05.1990; Elsevier Science
• Subjects: Anastomosis, Surgical - methods; Anastomosis, Surgical - mortality; Biological and medical sciences; Heart Defects, Congenital - surgery; Humans; Infant; Infant, Newborn; Medical sciences; Palliative Care - methods; Pulmonary Artery - diagnostic imaging; Radiography; Reoperation; Risk Factors; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart; Survival Rate; Vascular Patency; Human; Palliative surgery; Congenital; Cardiovascular disease; Cyanotic heart disease; Result; Blalock Taussig operation; Newborn; Treatment; Heart disease; Surgery; Process modification; Technique; Age
• ISSN: 0003-4975; 1552-6259
• DOI: 10.1016/0003-4975(90)90026-3

The optimal procedure for shunting palliation in cyanotic infants remains to be determined. Sixty-two infants less than 3 months of age underwent 33 modified Blalock-Taussig shunts. Their age range at operation was 1 to 84 days (mean, 16 ± 20 days). Shunts were constructed using 5-mm polytetrafluoroethylene tubes in 20 patients and 4-mm polytetrafluoroethylene grafts in 43 patients. There were 13 early deaths (21%: CL, 15% to 27%) of which three deaths (5%; confidence limits, 2% to 9%) were shunt related. The survivors were followed up from 6 to 53 months (mean, 29 ± 12.5 months). Shunt failure (occlusion, inadequate palliation) occurred in 27 patients. The overall probability rate of adequate shunt function was 58% ± 8% at 2 years. Univariate and multivariate analyses showed that the size of the graft was a risk factor of shunt failure. Severe distortion of the pulmonary arterial branch was noted in 12 patients. The inferences are: (1) modified Blalock-Taussig shunts provide satisfactory early palliation but late shunt failure is frequent; (2) similar results should be obtained with other shunting procedures; and (3) the optimal procedure should be selected for each cyanotic infant on an individual basis.