Cryopreserved Saphenous Vein Compared With PTFE Graft for Use as Modified Blalock-Taussig or Central Shunt in Cyanotic Congenital Heart Disease

Abstract

Many infants with congenital heart disease undergo palliative shunt procedures. In our center, cryopreserved saphenous vein and polytetrafluoroethylene (PTFE) are used as grafts to construct these shunts. In this retrospective review, we compare morbidity, mortality, and freedom from reoperation associated with the use of these graft materials. We conducted a retrospective study of 136 consecutive patients who were palliated with shunts between 2006 and 2015. A total of 136 patients were identified, 9 had incomplete data; thus, 127 patients were included: 69 saphenous and 58 PTFE. The cohorts were matched with respect to birth weight, gestational age, age and weight at time of surgery, and underlying cardiac condition. There were 15 (12%) deaths in the study cohort with no intraoperative mortality. Thrombosis was seen in 5.2% (2/38) of the saphenous modified Blalock-Taussig shunt (mBTS) group and 20.6% (14/68) of those with PTFE mBTS. There was no thrombosis in the central shunt group. Freedom from reoperation was 83% in the saphenous vein group and 81% in the PTFE group. There was no difference in overall morbidity or mortality, although thrombosis was significantly less in the saphenous vein group. Cryopreserved saphenous vein is a safe alternative, either as a mBTS or as a central shunt.

Exploratory Use of Glycoprotein IIb/IIIa Inhibition in Prevention of Blalock-Taussig Shunt Thrombosis*

“…Many centers report a correlation between coagulation factors and mBTTS occlusion such as: elevated postoperative PTT (1, 16, 17). Although, traditionally, polytetrafluoroethylene (PTFE) tube grafts are used to construct the shunt, saphenous vein grafts and heparin-coated PTFE tube grafts have been used with similar outcomes (19, 20). In addition to these previously reported risk factors, our study identified treatment with tirofiban in addition to SOC to be associated with lower risk for shunt thrombosis.…”

A summary of second systemic pulmonary shunt for congenital heart disease with pulmonary hypoxemia

“…Successful thoracic opening and closing is the prerequisite for successful reoperation [17][18][19]. In order to prevent ventricular fibrillation during the operation, we routinely place an external defibrillation electrode plate in case a ventricular fibrillation occurred and thus defibrillation can be performed timely.…”

Society for Cardiovascular Magnetic Resonance 2022 Cases of SCMR case series

“…Gore-Tex cardiac patch is a prosthetic material composed of polytetrafluoroethylene that is used as a conduit in various congenital heart disease repairs, including transannular patch for TOF repair. Thrombosis associated with Gore-Tex material, although rare, has been reported previously involving a Blalock-Thomas-Taussig (BTT) shunt, a central shunt, and Fontan palliation [65] , [66] , [67] .…”