Balloon dilation recanalization of completely occluded modified Blalock-Taussig shunt

Abstract

SummaryA two-month-old boy, with complex pulmonary atresia, became increasingly cyanosed 10 days after a modified 5 mm right Blalock-Taussig shunt. There was no shunt flow on auscultation or Doppler echocardiography. Despite anticoagulation with heparin, the shunt remained occluded. After demonstration of the occluded shunt at angiography, a guide wire was easily passed through the occlusion and into the pulmonary artery. Balloon dilation was then successfully accomplished with a 6 mm diameter angioplasty balloon resulting in a patent shunt. The shunt was still widely patent at cardiac catheterization six months later.

Recanalization of an occluded modified Blalock-Taussig shunt by balloon angioplasty within 12 hours of its construction

“…3 " 5 This procedure can be performed safely within three weeks of surgical construction of the shunt. 6 We report here recanalization by angioplasty within 12 hours of construction of the shunt, with an excellent outcome.…”

“…7 We reported one patient in whom balloon recanalization of a completely occluded systemicto-pulmonary shunt was performed without complications within three weeks of the operation. 6 At that time we commented "we cannot make recommendations on how soon after surgery one can attempt balloon recanalization safely".…”

Stent Implantation to Maintain Patency of a Stenosed Blalock Taussig Shunt

“…Balloon dilations of stenosed or totally occluded modified or classical Blalock Taussig (BT) shunts have been performed with variable results. 1 –8 There are rare reports describing balloon dilation of such shunts 10 years after surgery. 4 Our report shows successful balloon dilation and stent implantation of a nearly-occluded 5 mm in diameter classical BT shunt established 10 years earlier.…”