Modified Blalock-Taussig shunt

Leval, Marc R. de; McKay, Roxane; Jones, Michael; Stark, Jaroslav; Macartney, F J

doi:10.1016/s0022-5223(19)37668-8

Cited by 199 publications

(16 citation statements)

References 18 publications

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“…These materials were designed specifically to address the growth potential of the grafts, by replacing the artificial material used currently with a scaffold seeded to grow native tissue in its place. For the Norwood, previous studies determined that artificial grafts offered greater success in comparison to using neighboring native vessels in place of the shunt ( de Leval et al, 1981 ; Ullom et al, 1987 ). These findings suggest that native vessel growth may not be reflective of the necessary hemodynamic changes in this unique anatomy; indicating that sizing of a tissue-engineered graft would also present challenges.…”

Section: Discussionmentioning

confidence: 99%

Tunable Blood Shunt for Neonates With Complex Congenital Heart Defects

Garven

Rodell

Shema

et al. 2022

Front. Bioeng. Biotechnol.

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Despite advancements in procedures and patient care, mortality rates for neonatal recipients of the Norwood procedure, a palliation for single ventricle congenital malformations, remain high due to the use of a fixed-diameter blood shunt. In this study, a new geometrically tunable blood shunt was investigated to address limitations of the current treatment paradigm (e.g., Modified Blalock-Taussig Shunt) by allowing for controlled modulation of blood flow through the shunt to accommodate physiological changes due to the patient’s growth. First, mathematical and computational cardiovascular models were established to investigate the hemodynamic requirements of growing neonatal patients with shunts and to inform design criteria for shunt diameter changes. Then, two stages of prototyping were performed to design, build and test responsive hydrogel systems that facilitate tuning of the shunt diameter by adjusting the hydrogel’s degree of crosslinking. We examined two mechanisms to drive crosslinking: infusion of chemical crosslinking agents and near-UV photoinitiation. The growth model showed that 15–18% increases in shunt diameter were required to accommodate growing patients’ increasing blood flow; similarly, the computational models demonstrated that blood flow magnitudes were in agreement with previous reports. These target levels of diameter increases were achieved experimentally with model hydrogel systems. We also verified that the photocrosslinkable hydrogel, composed of methacrylated dextran, was contact-nonhemolytic. These results demonstrate proof-of-concept feasibility and reflect the first steps in the development of this novel blood shunt. A tunable shunt design offers a new methodology to rebalance blood flow in this vulnerable patient population during growth and development.

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Section: Discussionmentioning

confidence: 99%

Tunable Blood Shunt for Neonates With Complex Congenital Heart Defects

Garven

Rodell

Shema

et al. 2022

Front. Bioeng. Biotechnol.

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“…The original procedure of BT shunt was an end-toside anastomosis in which the subclavian artery was sacrificed (1,2). With the advent of artificial vessels made of materials such as Gore-Tex, a change in the procedure was introduced.…”

Section: Discussionmentioning

confidence: 99%

Perigraft seroma following Right Modified Blalock Taussig shunt in a child with complex cyanotic heart disease

Silva

Wijemanne

et al. 2013

Galle Med J

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“…Most of the patients with TA require symptomatic relief at initial presentation [22]. Babies with pulmonary oligemia are addressed with initial Prostaglandin E 1 infusion, followed by a modified Blalock-Taussig shunt operation [45] or other types of aortopulmonary Gore-Tex graft shunts. Infants with pulmonary plethora are treated with anticongestive measures (if they are in congestive heart failure (CHF)) followed by the banding of the PA [46].…”

Section: Summary Of Palliative/corrective Interventionsmentioning

confidence: 99%

Echocardiography in the Diagnosis and Management of Tricuspid Atresia

Rao

2021

Applied Sciences

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This review focuses on the utility of echocardiographic studies in the diagnosis of tricuspid atresia (TA) and in its management. Tricuspid atresia is a cyanotic congenital heart defect (CHD) accounting for nearly 1.5% of all CHDs. It is generally classified according to the morphology of the atretic tricuspid valve and associated heart defects. Following the description of the anatomic features of TA, echocardiographic features characteristic for TA were illustrated. Subsequent to a review of palliative and corrective procedures to treat TA, echocardiographic evaluation at each stage of Fontan was detailed. The role of echocardiography in the assessment of cardiac defects responsible for interstage mortality was also addressed. It was concluded that echo-Doppler studies are useful in the diagnosis and management of TA.

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Modified Blalock-Taussig shunt

Cited by 199 publications

References 18 publications

Tunable Blood Shunt for Neonates With Complex Congenital Heart Defects

Tunable Blood Shunt for Neonates With Complex Congenital Heart Defects

Perigraft seroma following Right Modified Blalock Taussig shunt in a child with complex cyanotic heart disease

Echocardiography in the Diagnosis and Management of Tricuspid Atresia

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