Optimal Surgical Management Using a Classic Blalock-Taussig Shunt for an Infected Pseudoaneurysm After a Modified Blalock-Taussig Shunt Procedure

• Published in: The Annals of thoracic surgery Vol. 101; no. 5; pp. 1992 - 1995
• Main Authors: Okada, Noritaka, MD, PhD, Murayama, Hiroomi, MD, Hasegawa, Hiroki, MD, PhD
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Inc 01.05.2016
• Subjects: Aneurysm, False - diagnostic imaging; Aneurysm, False - etiology; Aneurysm, False - surgery; Aneurysm, Ruptured - prevention & control; Angioplasty, Balloon; Anti-Bacterial Agents - therapeutic use; Blalock-Taussig Procedure; Blood Vessel Prosthesis - adverse effects; Blood Vessel Prosthesis Implantation - methods; Cardiothoracic Surgery; Carotid Artery Diseases - diagnostic imaging; Carotid Artery Diseases - etiology; Carotid Artery Diseases - microbiology; Carotid Artery Diseases - surgery; Carotid Artery, Common - diagnostic imaging; Carotid Artery, Common - microbiology; Carotid Artery, Common - pathology; Carotid Artery, Common - surgery; Disease Progression; Esophagostomy; Female; Heart Defects, Congenital - surgery; Hemodynamics; Humans; Imaging, Three-Dimensional; Infant; Male; Methicillin Resistance; Prosthesis-Related Infections - diagnostic imaging; Prosthesis-Related Infections - drug therapy; Prosthesis-Related Infections - microbiology; Prosthesis-Related Infections - surgery; Pulmonary Atresia - surgery; Serratia Infections - drug therapy; Serratia Infections - microbiology; Serratia Infections - surgery; Staphylococcal Infections - drug therapy; Staphylococcal Infections - microbiology; Staphylococcal Infections - surgery; Staphylococcus epidermidis - drug effects; Staphylococcus epidermidis - isolation & purification; Surgery; Tomography, X-Ray Computed; Tracheoesophageal Fistula - surgery
• ISSN: 0003-4975; 1552-6259
• DOI: 10.1016/j.athoracsur.2015.07.057

We present 2 cases of a 3-month-old girl and boy who were diagnosed with an infected pseudoaneurysm 2 months after undergoing left-sided modified Blalock-Taussig shunt (mBTS) operations for pulmonary atresia. Because the shunts in both cases were nearly obstructed, they underwent a 2-stage surgical approach: classic BTS operations through a right thoracotomy to establish sufficient pulmonary flow and infected graft removal through a median sternotomy after close observation of the state of the aneurysms. By utilizing autologous tissue from a different thoracic entry, both patients were successfully managed and recovered without any recurrence of infection.