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Background: Modified Blalock-Taussig Shunt is the most commonly used palliative shunt procedure in congenital heart disorders and is associated with significant morbidity and mortality. Aim: to improve the outcome following this surgical intervention. Subjects and Methods: Data about all children undergoing Modified Blalock-Taussig Shunt in Suez Canal University Hospitals and Cairo University Specialized Children Hospital in the time interval between March 2014 and February 2015 has been collected in three phases; pre-intra-and post-operatively then analyzed statistically. Results: Mortality in our study was 50%. The main risk factors for mortality in our study were weight urgency pre-operative prostene infusion cardiopulmonary bypass graft size and wound infection. Regarding shunt occlusion weight shunt size and intra-operative administration of protamine were statistically significant risk factors. Conclusion: Mortality rates decreased significantly with increasing weight. Cardiopulmonary Bypass graft size and wound infection were noted to be definite risk factors for mortality. Regarding acute shunt occlusion risk factors of statistical importance were weight intra-operative protamine and graft size.

Delirium is a prevalent complication in critically ill medical and surgical cardiac patients. It is associated with increased morbidity and mortality, prolonged hospitalizations, cognitive impairments, functional decline, and hospital costs. The incidence of delirium in cardiac patients varies based on the criteria used for the diagnosis, the population studied, and the type of surgery (cardiac or not cardiac). Delirium experienced when cardiac patients are in the intensive care unit (ICU) is likely preventable in most cases. While there are many protocols for recognizing and managing ICU delirium in medical and surgical cardiac patients, there is no homogeneity, nor are there established clinical guidelines.This review provides a comprehensive overview of delirium in cardiac patients and highlights its presentation, course, risk factors, pathophysiology, and management. We define cardiac ICU patients as both medical and postoperative surgical patients with cardiac disease in the ICU. We also highlight current controversies and future considerations of innovative therapies and nonpharmacological and pharmacological management interventions. Clinicians caring for critically ill patients with cardiac disease must understand the complex syndrome of ICU delirium and recognize the impact of delirium in predicting long-term outcomes for ICU patients.

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