63-year Survival after Blalock-Taussig Shunt Operation in a Patient with Single Ventricle, Tricuspid Atresia, and Pulmonary Stenosis

Scholtz, Werner; Jategaonkar, Smita; Dimitriadis, Zisis; Haas, Nikolaus A.; Horstkotte, Dieter

doi:10.1111/j.1747-0803.2010.00469.x

Cited by 3 publications

(1 citation statement)

References 10 publications

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“…Even a 60-year survival of the BTS had been reported. 6 Only two Waterston shunts were performed. These were during the earlier part of the study.…”

Section: Discussionmentioning

confidence: 99%

Experience with Palliative Procedures for Congenital Cyanotic Heart Diseases in Ghana: A 20-Year Review

Tamatey¹,

Sereboe²,

Tettey³

et al. 2022

pmjg

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Background:Currently, in the management of congenital cyanotic heart diseases with favourable anatomy, primary correction is the preferred choice. But palliative procedures have still maintained an important role in resource-poor regions of the world.We sought to analyze our institutional results for such palliation over a 20-year period. The purpose of the study was to provide information that would guide both practitioners and referring doctors on the future management of congenital cyanotic heart diseases, and also to provide data for comparative studies in the sub region in the future.Patients and Methods: A retrospective study was carried out in the National Cardiothoracic Centre involving all patients who had palliative procedures for congenital cyanotic heart diseases from January 1992 to December 2011.Results: There were 264 patients, 59% males and 41% females. The case load increased from 2 cases per year in the first year to 34 in the last year of the study. The age range was 4 months – 42 years, with a mean of 7.1 ± 6.9 years. Tetralogy of Fallot comprised 257 (97.4%) of the cases, tricuspid atresia 4 (1.5%), and double outlet right ventricle 3 (1.1%). The modified Blalock-Taussig shunt (MBTS) was performed in 262 (92.2%), and the Waterston shunt in 2 (0.8%) of the cases. The overall complication rate was 11.8%, comprising shunt occlusion 7.6%, bleeding requiring re-exploration 0.8% and early mortality of 3.4%.Conclusion: The modified Blalock-Taussig shunt provided good palliation for congenital cyanotic heart diseases in this environment. We consider it a suitable management alternative when financial and logistic constraints delay primary repair in resource-poor settings.

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“…Even a 60-year survival of the BTS had been reported. 6 Only two Waterston shunts were performed. These were during the earlier part of the study.…”

Section: Discussionmentioning

confidence: 99%

Experience with Palliative Procedures for Congenital Cyanotic Heart Diseases in Ghana: A 20-Year Review

Tamatey¹,

Sereboe²,

Tettey³

et al. 2022

pmjg

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Fifty Years of Surgery for Single Ventricle: Now What?

Mahle

Border

2012

The Journal of Pediatrics

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Stenting of modified Blalock–Taussig shunt in adult with palliated pulmonary atresia and ventricular septal defect: a case report

Illner

Reinecke

Baumgartner

et al. 2019

European Heart Journal - Case Reports

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Background Adults with complex congenital heart disease palliated with systemic-to-pulmonary artery shunts have become rare and represent a particularly challenging patient group for the cardiologist. One of the complications and causes of severe clinical deterioration during long-term follow-up are progressive obstruction or total occlusion of the shunt. The risk for surgical intervention is frequently high and catheter intervention may be complicated by complex anatomy and shunt calcification. Case summary We report the case of a 47-year-old man with uncorrected (palliated) pulmonary atresia and ventricular septal defect who presented with progressive cyanosis (oxygen saturation 69%) and decreasing exercise capacity. Computed tomography revealed a totally occluded modified left Blalock–Taussig (BT) shunt and a severely stenosed central shunt (Waterston–Cooley) in a patient with confluent but hypoplastic pulmonary arteries and multiple major aortic pulmonary collaterals. Due to a high operative risk, an interventional, percutaneous approach was preferred to re-do surgery. From a radial access the calcified BT shunt could be crossed with a hydrophilic guidewire. Then, a rotational thrombectomy, balloon dilatation, and bare-metal stenting at the proximal and distal anastomoses were performed. Post-interventionally, peripheral oxygen saturation increased from 69% to 82%. Clopidogrel was administered for 1 month after bare-metal stenting. At 1-year follow-up, the BT shunt was still patent on echocardiography and exercise tolerance markedly improved. Discussion This case highlights the benefit of percutaneous rotational thrombectomy followed by stenting of chronically occluded systemic-to-pulmonary artery shunts for further palliation in adult patients with complex congenital heart disease not suitable for surgical repair.

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63-year Survival after Blalock-Taussig Shunt Operation in a Patient with Single Ventricle, Tricuspid Atresia, and Pulmonary Stenosis

Cited by 3 publications

References 10 publications

Experience with Palliative Procedures for Congenital Cyanotic Heart Diseases in Ghana: A 20-Year Review

Experience with Palliative Procedures for Congenital Cyanotic Heart Diseases in Ghana: A 20-Year Review

Fifty Years of Surgery for Single Ventricle: Now What?

Stenting of modified Blalock–Taussig shunt in adult with palliated pulmonary atresia and ventricular septal defect: a case report

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