Pleural flap for treating perigraft leak after a modified blalock-taussig shunt

Uğurlu, Baran; Sariosmanoğlu, Osman Nejat; Metin, Sadık Kıvanç; Hazan, E; Oto, Öztekin

doi:10.1016/s0003-4975(01)03365-3

Cited by 5 publications

(5 citation statements)

References 7 publications

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“…2 Seroma following modified BT shunt is a rare complication with an incidence ranging from 4% to 20%. 3,4 The age of presentation is from 9 days to 7 years and is slightly more common in females. 5 The time taken for seroma formation is variable, can occur in the first post operative day to years later 6 but commonly within 30 days of surgery.…”

Section: Discussionmentioning

confidence: 99%

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Post Blalock–Taussig shunt mediastinal mass – a single shadow with two different destinies

Rohit

Vadivelu

Khandelwal

et al. 2014

Indian Heart Journal

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The modified Blalock-Taussig shunt is a synthetic shunt between the subclavian and pulmonary artery, used in the treatment of congenital cyanotic heart diseases with pulmonary hypoperfusion. Delayed complications include progressive failure of the shunt, serous fluid leak, and pseudoaneurysm formation. We report two different and rare mediastinal vascular complications following modified BT shunt surgery in this case report. The first one is a seroma, due to serous fluid leakage through the shunt graft, which is a relatively benign complication. The second one is a pseudoaneurysm, arising from the shunt, a frequently fatal complication. Generally, X-ray chest is used for screening in these patients. CT angiography plays a vital role in the diagnosis of both these conditions. Management in pseudoaneurysm should be aggressive, as timely intervention may be life saving, while in seroma the management is most often conservative occasionally requiring surgical intervention.

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Section: Discussionmentioning

confidence: 99%

“…Pleural wrapping of the PTFE graft can be done with parietal pleura. 3 But these techniques may be associated with high recurrence rates, necessitating surgical replacement of the graft. Surgical management is required in cases of mediastinal or vascular compression.…”

Section: Discussionmentioning

confidence: 99%

Post Blalock–Taussig shunt mediastinal mass – a single shadow with two different destinies

Rohit

Vadivelu

Khandelwal

et al. 2014

Indian Heart Journal

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“…The classical indications for the modified Blalock-Taussig shunt, based on echocardiographic diagnosis, are well established. 13 Also well established are shuntrelated complications, [3][4][5][6][7][8]14 postoperative evaluation of the shunt itself and of the pulmonary arteries, 6,15 and the growth of the pulmonary arteries after a systemicpulmonary artery shunt. 15,16 A more recent indication is its use with pulmonary artery banding and atrioseptectomy on cardiopulmonary bypass for children with transposition of the great arteries undergoing left ventricular retraining because of late referral.…”

Section: Discussionmentioning

confidence: 99%

“…This observation is confirmed by numerous recent reports on this procedure, including those on a computational model of this procedure, 2 its wide clinical application as a palliative approach, 3 a technical modification, 4 postoperative diagnosis, 5 and postoperative complications. [5][6][7][8][9][10] Furthermore, the modified Blalock-Taussig shunt is needed for the first-stage palliation of hypoplastic left heart syndrome 9 and for the more complex surgical approach of left ventricular retraining in preparation for arterial switch in late referral cases of transposition of the great arteries. 10,11 Following our initial clinical experience a few years ago 12 with the modified Blalock-Taussig shunt using a tubular accordion-like prosthesis, we report now the intermediateterm results of a prospective study in a larger group of patients operated on with the same technique.…”

Section: Introductionmentioning

confidence: 99%

Accordion-Like Prosthesis for Modified Blalock-Taussig Shunt

Corno

Hurni

Tozzi

et al. 2003

Asian Cardiovasc Thorac Ann

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From March 1996 to July 2002, 26 consecutive patients, with a mean age of 17.9 months and a mean body weight of 6.6 kg, underwent the modified Blalock-Taussig shunt with a tubular accordion-like prosthesis. In a mean follow-up period (defined as the interval between the shunt procedure and repair or last evaluation) of 10.9 months (range, 1 to 32 months), there were 1 death due to excessive pulmonary blood flow in a neonate with hypoplastic left heart syndrome and 3 reoperations to correct shunt-related problems, 2 of them early and 1 late (to regulate pulmonary blood flow after left ventricular retraining for transposition of the great arteries). There was no occurrence of shunt obstruction or kinking. Other shunt-related early complications, such as bleeding, infection, or serous fluid leakage, did not occur, and no patient needed pulmonary artery reconstruction during surgical repair. Shunt patency was confirmed by Doppler echocardiography in all patients and also by angiography in 73% of the patients. This prospective study confirmed our preliminary results with this prosthesis. The use of this prosthesis is justified for reducing early and late complications potentially associated with the modified Blalock-Taussig shunt, particularly distortion of the pulmonary arteries.

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“…Possible causes include the inhibition of humoral fibroblasts, wetting of the wall of the graft, and increased porosity after handling the graft during its insertion. Various methods have been suggested to tackle this problem, [1][2][3] with variable rates of success. We report 2 patients who developed severe perigraft seromas following construction of a leftsided modified Blalock-Taussig shunt, who were treated simply by reducing the length of the graft.…”

mentioning

confidence: 99%