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Outcomes of Infants Undergoing Modified Blalock-Taussig Shunt Procedures in Oman: A retrospective study
Samiuddin Shaikh1, Khaloud S Al-Mukhaini1, Abdul Hakeem Al-Rawahi2
1Department of Pediatric Intensive Care, Royal Hospital, Muscat, Oman.
Insights
This study on modified Blalock-Taussig (mBT) shunts in Oman found preoperative mechanical ventilation and cardiopulmonary bypass significantly increase early mortality risk in pediatric cyanotic congenital heart disease patients.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Surgery
- Public Health
Background:
- Cyanotic congenital heart disease (CCHD) often requires palliative surgery in infants and children.
- The modified Blalock-Taussig (mBT) shunt is a common palliative procedure for CCHD.
- Outcomes and risk factors for mBT shunts in Oman were previously unreported.
Purpose of the Study:
- To report outcomes of mBT shunt procedures in Omani infants and children with CCHD.
- To identify risk factors for early mortality, inter-stage mortality, and reintervention after mBT shunts.
- To compare findings with international research on mBT shunt risks.
Main Methods:
- Retrospective cohort study from January 2016 to December 2018 at Oman's National Heart Centre.
- Inclusion of all pediatric CCHD patients undergoing primary mBT shunt procedures.
- Data analysis using electronic records and Kaplan-Meier survival curves.
Main Results:
- 50 pediatric patients with CCHD were included.
- In-hospital and inter-stage mortality rates were 10% and 6.7%, respectively.
- Preoperative mechanical ventilation (OR=3.00) and cardiopulmonary bypass (OR=4.09) were significant risk factors for early mortality.
Conclusions:
- mBT shunt outcomes in Oman align with international findings.
- Preoperative mechanical ventilation and cardiopulmonary bypass are key risk factors for early mortality in mBT shunt surgery.
- Further research may inform risk stratification and management strategies for CCHD patients.
Objectives:
A modified Blalock-Taussig (mBT) shunt procedure is a common palliative surgery used to treat infants and children with cyanotic congenital heart disease (CCHD). This study aimed to report the outcomes of infants and children undergoing mBT shunt procedures in Oman. In addition, risk factors associated with early mortality, inter-stage mortality and reintervention were assessed.
Methods:
This retrospective cohort study was conducted from January 2016 to December 2018 at the National Heart Centre, Muscat, Oman. All paediatric patients with CCHD undergoing mBT shunt procedures as a primary palliative procedure during this period were included. Data were retrieved from electronic hospital records. Kaplan-Meier survival curves were used to describe overall survival.
Results:
A total of 50 infants and children were included in this study. The in-hospital mortality and interstage mortality rates were 10% and 6.7%, respectively. Preoperative mechanical ventilation (odds ratio [OR] = 3.00, 95% confidence interval [CI]: 1.98-4.76; P = 0.007) and cardiopulmonary bypass (OR = 4.09, 95% CI: 2.44-6.85; P = 0.002) were significant risk factors for early mortality. In-hospital and interval surgical reintervention rates were 12% and 13.3%, respectively. Following the primary shunt procedure, the median time to second-stage surgery was 15.5 months (range: 5.0-34.0 months).
Conclusion:
The findings of this study support those reported in international research regarding the risks associated with mBT shunt surgeries. In particular, preoperative mechanical ventilation and cardiopulmonary bypass were significant risk factors for early mortality.
