Hybrid approach to surgical correction of tetralogy of Fallot in all patients with functioning Blalock Taussig shunts

Sivakumar, Kothandam; Krishnan, Prasad; Pieris, Rajeeva; Francis, Edwin

doi:10.1002/ccd.21126

Cited by 15 publications

(7 citation statements)

References 51 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A surgeon may leave a BT anastomosis when the risk of surgical ligation is too high, when the corrective surgery is performed with the access, which makes it difficult to close the anastomosis, or when it is believed that despite the correction of a defect a patient may require additional blood flow to the pulmonary circulation. In the literature, the closure of a modified BT shunt with interventional cardiology procedures during hybrid procedures has also been described [6]. In our patient, the preoperative diagnostic procedures revealed no flow through the previously established leftsided BT anastomosis either in angiography or in echocardiography.…”

Section: Discussionmentioning

confidence: 64%

Transcatheter closure of Blalock-Taussig anastomosis with brachial access in a child with obstruction of the left subclavian artery and secondary subclavian steal syndrome

Surmacz¹,

Moszura²,

Mroziński³

et al. 2012

pwki

View full text Add to dashboard Cite

A b s t r a c tIn case of significant hypoxia in the course of congenital heart defect, when definite surgery is difficult, various palliative procedures are performed. One of the most frequently used is a modified Blalock-Taussig (BT) anastomosis. The BT anastomosis is closed during cardiac surgery. In some patients, BT anastomosis remains open after the surgery and requires closure by cardiac intervention using different types of closure devices. We describe a case of percutaneous closure of Blalock-Taussig anastomosis in a 4-yearold boy, with occluded left subclavian artery, presence of collateral circulation, and the subclavian artery steal syndrome to the left pulmonary artery through the patent BT anastomosis.Key words: Blalock-Taussig anastomosis, percutaneous closure S t r e s z c z e n i e W przypadku istotnego niedotlenienia w przebiegu wrodzonej sinicznej wady serca oraz niemożności przeprowadzenia operacji radykalnej u pacjentów wykonuje się różnego rodzaju zabiegi łagodzące. Jednym z częściej wykonywanych jest zmodyfikowane zespolenie Blalocka-Taussig (BT). Elementem końcowej korekcji wady jest zamknięcie zespolenia podczas operacji kardiochirurgicznej. U niektórych pacjentów, z różnych powodów, zespolenie BT pozostaje drożne po zabiegu i wymaga zamknięcia interwencyjnego z zastosowaniem różnego rodzaju implantów. Przedstawiono przypadek przezskórnego zamknięcia zespolenia BT u 4-letniego chłop-ca z niedrożnością lewej tętnicy podobojczykowej z obecnością krążenia obocznego przez tętnicę kręgową oraz zespołem podkradania do lewej tętnicy płucnej przez drożne zespolenie BT.Słowa kluczowe: zespolenie Blalocka-Taussig, zamknięcie przezskórne

show abstract

Section: Discussionmentioning

confidence: 64%

Transcatheter closure of Blalock-Taussig anastomosis with brachial access in a child with obstruction of the left subclavian artery and secondary subclavian steal syndrome

Surmacz¹,

Moszura²,

Mroziński³

et al. 2012

pwki

View full text Add to dashboard Cite

show abstract

“…Surgical closure of BT shunts is usually associated with an extended hospital stay, with high risk due to sternum re-incision, and a need for blood transfusions, with nerve and thoracic duct injury. At the same time, percutaneous closure is not a routine procedure; while it is technically challenging, it carries a higher rate of device embolization to the pulmonary artery [8][9][10][11][12]. Perry et al occluded fourteen BTSs; in three patients, embolization of the overflowing shunt after surgical correction of AAP/IVS and PS eliminated the need for further surgery [10]; meanwhile, Sivakumar et al performed a hybrid approach to occlude BTS before the surgical correction of Tetralogy of Fallot [11].…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Modified Blalock–Taussig Shunt Closure in a Patient with Isolated Right Ventricular Hypoplasia

Krasic,

Dizdarevic,

Vranic

et al. 2023

JCDD

View full text Add to dashboard Cite

Clinical presentation, course, and treatment for patients with isolated right ventricular (RV) hypoplasia (IRVH) depends on the degree of hypoplasia that is present—this is a spectrum from spontaneous maturation to Fontan circulation over time. An 8-month-old infant presented with IRVH; in the patient, a modified Blalock–Taussig (MBTS) shunt was closed percutaneously after spontaneous RV function recovery. A female newborn was diagnosed with differential cyanosis at birth. The echocardiography showed a hypertrophic RV with a small cavity, a right–left shunt on the atrial septal defect, an almost closed ductus arteriosus (DA), and a small tricuspid valve ring (Z-score-2) with mild regurgitation (pressure gradient 30 mmHg). On the 4th day of life, the patient showed deepened cyanosis and hyperlactatemia was registered. The echocardiography examination revealed a closed DA. Right ventriculography performed on the 5th day of life evidenced the presence of a small hypertrabeculated RV. The pressure in the RV increased. A right-side MBTS was created on the 6th day of life. Further echocardiographic findings indicated a gradual development of the RV and a decrease in RV pressure. MBTS occlusion was performed when the patient was 8 months old. Vital parameters were monitored invasively and noninvasively after the balloon occlusion of MBTS. Percutaneous MBTS occlusion was successfully performed using an Amplatzer vascular plug 2 (AVP2). During the follow-up period, the patient was found to have maintained a normal percutaneous oxyhaemoglobin blood saturation.

show abstract

“…Hence, percutaneous closure may be preferred [3, 4]. A few centers have even adopted a hybrid approach of routine percutaneous closure of the BT shunt followed by corrective surgery for the aforementioned reasons [5].…”

Section: Case Discussionmentioning

confidence: 99%

“…The use of the detachable coil system Duct‐Occlud (PFM, Bonn‐Germany) or the detachable Jackson coil (Cook Cardiology, Bloomington, IN) or a bioptome held coils as described for duct closure provides an excellent alternative. Ductal occluders are useful in transarterial or transvenous occlusion of a BT shunt [2, 5]. We selected vascular plug in view of easy tractability and better profile, so that it could be advanced over a right coronary guiding catheter.…”

Section: Case Discussionmentioning

confidence: 99%

Amplatzer vascular plug closure of a Blalock–Taussig shunt through a Glenn shunt

Ramakrishnan¹,

Ss²

2008

Cathet Cardio Intervent

View full text Add to dashboard Cite

We describe an unusual route and uncommon device use for the percutaneous closure of a modified Blalock-Taussig (BT) shunt. A 4-year-old male had presented with severe upper body swelling after a bidirectional Glenn shunt done one month earlier. The BT shunt which was clipped during the surgery was found to be patent. The BT shunt was finally closed from the bidirectional Glenn using an Amplatzer vascular plug, resulting in symptom relief.

show abstract

Hybrid approach to surgical correction of tetralogy of Fallot in all patients with functioning Blalock Taussig shunts

Abstract: Hybrid approach using routine transcatheter closure of all BTS immediately before surgical correction of TOF shunts with coils/plugs/devices is safe, feasible, and reproducible.

Cited by 15 publications

References 51 publications

Transcatheter closure of Blalock-Taussig anastomosis with brachial access in a child with obstruction of the left subclavian artery and secondary subclavian steal syndrome

Transcatheter closure of Blalock-Taussig anastomosis with brachial access in a child with obstruction of the left subclavian artery and secondary subclavian steal syndrome

Percutaneous Modified Blalock–Taussig Shunt Closure in a Patient with Isolated Right Ventricular Hypoplasia

Amplatzer vascular plug closure of a Blalock–Taussig shunt through a Glenn shunt

Contact Info

Product

Resources

About