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Blalock-Taussig shunt: experience from the developing world
Jamal S Rana1, Kaashif A Ahmad, Aliya S Shamim
1School of Medicine, The Aga Khan University, Karachi, Pakistan. jrana@caregroup.harvard.edu
Background:
Palliative procedures have a role in congenital cardiac malformations that do not permit a complete early repair, and in centres where facilities for complete early repair do not exist. The lack of data on modified Blalock-Taussig shunt from developing countries prompted this analysis.
Methods:
We report a retrospective study of 70 Blalock-Taussig shunt procedures in 63 patients over an 8-year period. Most of the procedures (54.0%) were done on children less than 4 months of age. Thirty-nine (58%) patients had Tetralogy of Fallot; the remaining patients had a wide spectrum of lesions.
Results:
In the first year of the review period, the classical Blalock-Taussig shunt was done in six patients (9.5%) and the modified Blalock-Taussig shunt was used thereafter. In 49 patients who were followed up long term, clinical congestive cardiac failure developed in three (6%) and shunt failure was reported in 10 (14%). Of the 16 (33%) total deaths, six had serious comorbid conditions preoperatively.
Conclusions:
The Blalock-Taussig shunt is a relatively safe palliative procedure, requiring fewer resources and less expertise than corrective surgery, making it a suitable option in developing countries.
