2010
DOI: 10.1177/0218492310375856
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Sternotomy Approach for Modified Blalock-Taussig Shunt: Is it a Safe Option?

Abstract: Central aorta-pulmonary artery shunts have fallen into disfavor because of shunt thrombosis and congestive heart failure, and a modified Blalock-Taussig shunt via thoracotomy can lead to pulmonary artery hypoplasia and distortion. We reviewed the outcomes of a modified Blalock-Taussig shunt by a sternotomy approach in 20 infants from July 2007 to October 2009. Their mean age was 5.79 months, and median weight was 5.4 kg. A 4-mm graft was placed in 11 patients, a 5-mm graft in 8, and a 3.5-mm graft in 1. There … Show more

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Cited by 12 publications
(8 citation statements)
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“…The overall mortality and infant mortality of 4.5% and 8%, respectively is comparable with other studies. [7,15,17,21] No child older than 1 year died. This significant difference in mortality could be due to larger vessels, less vulnerable physiology and technically less demanding surgery in older children.…”
Section: Discussionmentioning
confidence: 99%
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“…The overall mortality and infant mortality of 4.5% and 8%, respectively is comparable with other studies. [7,15,17,21] No child older than 1 year died. This significant difference in mortality could be due to larger vessels, less vulnerable physiology and technically less demanding surgery in older children.…”
Section: Discussionmentioning
confidence: 99%
“…[4] Earlier, the classic BT shunt was replaced by the MBTS where a PTFE graft is placed between the SCA and branch PA. Now the most widely used technique of de Leval [16] (via posterolateral thoracotomy) is being challenged by the proponents of sternotomy. [7,8,17] Odim et al [7] reported that a MBTS was 4 times more likely to fail if performed via thoracotomy rather than sternotomy. Kandakure et al, [17] emphasized that thoracotomy approach can cause distal PA distortion and since the shunt is placed more centrally through sternotomy the growth of branch PAs is more uniform.…”
Section: Discussionmentioning
confidence: 99%
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“…A central‐type shunt made from a Gore‐Tex graft has been demonstrated to cause congestive heart failure due to difficulty controlling the blood flow. To reduce this complication, the graft size has been previously designed based on the patient's age and body mass index . These guidelines have been applied to a wide range of patient's weight, most of which are neonates whose pulmonary vascular bed is in a development phase with marked reduction in pulmonary vascular resistance as the child grows.…”
Section: Discussionmentioning
confidence: 99%
“…In our study, 41 patients received the second corrective operation and no pulmonary artery distortion was found. Kandakure et al and Amato et al showed that the shunt through a median sternotomy approach would not likely distort the pulmonary artery compared with the thoracotomy approach.…”
Section: Discussionmentioning
confidence: 99%