Two thousand Blalock-Taussig shunts: a six-decade experience

Area of Science:

• Cardiology
• Pediatric Cardiology
• Congenital Heart Disease Surgery

Background:

• The Blalock-Taussig shunt (BTS) is a critical palliative procedure for congenital heart disease.
• Its application and outcomes have evolved over time, necessitating a review of long-term institutional experience.

Purpose of the Study:

• To analyze changes in the utilization and outcomes of the Blalock-Taussig shunt (BTS) over a 62-year period.
• To examine trends in patient demographics, diagnoses, and surgical approaches related to BTS.

Main Methods:

• A retrospective review of 2,016 Blalock-Taussig shunts performed between November 1944 and May 2006.
• Evaluation of hospital and autopsy records for patient data, operative details, complications, and long-term outcomes.

Main Results:

• Over 62 years, 2,016 BTS procedures were performed on 1,880 patients; 75% were classic BTS.
• Operative mortality decreased from 16% to 9% over the study period.
• There was a shift in diagnoses, with an increasing proportion of single-ventricle defects (5% to 34%) and decreasing use for tetralogy of Fallot.

Conclusions:

• The Blalock-Taussig shunt (BTS) shows decreased overall use, particularly for tetralogy of Fallot.
• Its application has increased for single-ventricle cardiac lesions.
• Improved operative survival rates demonstrate the evolving efficacy of BTS in managing complex congenital heart disease.