Novel technique of achieving hemodynamic stability during systemic to pulmonary artery shunt

Historically, the Blalock Taussig (BT) shunt has been an off-pump procedure. For the last two decades, the number of BT shunt operations has come down globally with the adoption of neonatal early corrective surgery. BT shunts are still performed for augmentation of pulmonary arterial (PA) growth or as a part of univentricular palliation. Many infants do not tolerate PA branch clamping while undergoing the graft to PA anastomosis, necessitating institution of cardiopulmonary bypass (CPB). Since the threshold to go on CPB for shunt placement is quite low at most institutions, our technical modification described can avoid deleterious effect of CPB. Our point of interest is to maintain lung perfusion by adopting few principles of off-pump coronary artery bypass surgery.