The Blalock-Taussig Shunt

Abstract

Background and aim of the study: Even though the Blalock-Taussig (B-T) shunt, either classic or modified, has been advocated and successfully employed in clinical practice for more than half a century, a systemic review on this procedure is still scanty. This warrants us a zest in making a comprehensive survey on this subject. Methods: Articles were extensively retrieved from the MEDLINE database of National Library of Medicine USA if the abstract contained information relevant to the B-T shunt in terms of the conduit options, modified surgical techniques, surgical indications, short-and long-term results, complications, and prognosis. Further retrieval was undertaken by manually searching the reference list of relevant papers. Results: Classical or modified B-T shunts, either on ipsilateral or contralateral side to the aortic arch, can be performed on patients of any age with minimum postoperative complications and low operative mortality. Expended polytetrafluoroethylene has gained satisfactory long-term patency rate in the construction of the modified B-T shunt. Excellent pulmonary artery growth was observed in the patients with a modified B-T shunt, and it has shown superb prognosis over the classic with regard to hemodynamics, patency rate, and survival. Conclusions: The modified B-T shunt that was developed on basis of the classic fashion remains the preferable palliative procedure aiming at enhancing pulmonary blood flow for neonates and infants with complicated cyanotic congenital heart defects. The modified B-T shunt is technically simpler with less dissection, and blood flow to the respective arm is not jeopardized. It has been proved to be of low risk, excellent palliation, and is associated with excellent pulmonary artery growth, has become the most effective palliative shunt procedure of today. doi: 10.1111/j.1540-8191.2008.00758.x (J Card Surg 2009;24:101-108) Complex cyanotic congenital heart disease may occasionally be unsuitable for surgical correction, but for palliative procedure only. 1 In 1945, prior

Modified Blalock Taussig shunt: Comparison between neonates, infants and older children

“…[5] The conventional approach for performing a MBTS is via thoracotomy incision, usually on the side opposite to the aortic arch (the right subclavian artery (SCA) arising from the innominate artery is more easily mobilized than the left SCA). However, sternotomy approach is advocated and practiced by some surgeons citing the disadvantages of thoracotomy approach including distortion of the branch PA, unbalanced growth of the branch PAs, delayed healing of thoracotomy wounds in children who remain cyanotic, onset of late scoliosis, development of collaterals from the chest wall to lung, phrenic nerve injury, damage to the sympathetic ganglia and cosmetic concerns in children undergoing MBTS via thoracotomy.…”

Hemodynamic Effects of the Anastomoses in the Modified Blalock–taussig Shunt: A Numerical Study Using a 0d/3d Coupling Method

“…2 Modified Blalock-Taussig (BT) shunts, as a palliative surgery on severe variant infants with TOF such as TOF with pulmonary atresia (pseudotruncus arteriosus), aims to increase the blood oxygen saturation by interposing a systemic-to-pulmonary artery shunt between the innominate artery (IA) and pulmonary artery (PA). 3 For this disease, the method of evaluating a structure to discuss the cardiovascular condition is important because the heart pertains to the cardiovascular structure. 4 The end-to-side (ETS) and side-to-side (STS) anastomosis are normally used in clinical practice.…”

Cardiac output monitoring during Cesarean delivery in a patient with palliated tetralogy of Fallot

“…This increases the volume of blood entering the pulmonary vasculature; however, it rarely causes overperfusion. 8 This procedure will improve the systemic oxygenation but does not fully reverse cyanosis as there is still a shunt at the ventricular level. Over time, there is strain on the low pressure pulmonary circulation, which eventually leads to pulmonary hypertension and right ventricular failure.…”