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The Blalock-Taussig shunt in the first six months of life
Insights
The Blalock-Taussig shunt is a viable option for infants under six months, with a 70% patency rate. However, mortality is higher in neonates under two weeks old, suggesting caution for this specific group.
Area of Science:
- Pediatric Cardiac Surgery
- Congenital Heart Defect Management
Background:
- The Blalock-Taussig shunt is increasingly applied in younger infants.
- Previous concerns existed regarding late complications with the Waterston shunt.
Purpose of the Study:
- To evaluate the efficacy and safety of the Blalock-Taussig shunt in infants aged 6 months or less.
- To compare outcomes with alternative palliative procedures.
Main Methods:
- Retrospective review of 18 infants aged 6 months or less who underwent the Blalock-Taussig procedure.
- Analysis of mortality and shunt patency rates based on age at surgery.
Main Results:
- Overall shunt patency rate was 70%.
- Mortality rate was 50% for infants under 2 weeks of age.
- Mortality rate was 28% for infants aged 2 weeks to 6 months.
Conclusions:
- The Blalock-Taussig procedure demonstrates acceptable outcomes in infants up to 6 months.
- Consideration should be given to the increased mortality risk in neonates under 2 weeks.
- The Blalock-Taussig shunt is recommended over the Waterston shunt due to comparable mortality and fewer late issues.
Abstract:
Because of increasing interest in the application of the Blalock-Taussig shunt in smaller infants, we reviewed the course of 18 infants aged 6 months or less who underwent this procedure. The mortality rate in 4 infants under 2 weeks of age was 50 per cent and that in those 2 weeks to 6 months of age, 28 per cent. The patency rate was 70 per cent. Because of late problems with the Waterston shunt and a comparable mortality rate, the Blalock-Taussig procedure is recommended for all infants, except perhaps those under 2 weeks of age.