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The Blalock-Taussig shunt. Low risk, effective palliation, and pulmonary artery growth
Insights
The Blalock-Taussig shunt offers safe and effective palliation for infants with cyanotic congenital heart disease. This surgical procedure demonstrates good long-term function and promotes excellent pulmonary artery growth.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Surgery
Background:
- Cyanotic congenital heart disease (CCHD) requires surgical palliation in infants.
- The Blalock-Taussig (BT) shunt is a common palliative procedure.
Purpose of the Study:
- To evaluate the safety, efficacy, and impact on pulmonary artery growth of the Blalock-Taussig shunt in infants with CCHD.
Main Methods:
- Retrospective review of 64 infants undergoing BT shunt for CCHD.
- Analysis of early outcomes, shunt patency using life-table analysis, and pulmonary artery growth.
Main Results:
- Low hospital mortality (3%) with no early shunt closures.
- Shunt function at 1 and 2 years was 87% +/- 9% and 78% +/- 12%, respectively.
- Significant and excellent pulmonary artery growth observed post-operatively.
Conclusions:
- The Blalock-Taussig shunt is a low-risk procedure for infant CCHD palliation.
- It provides effective long-term palliation and promotes favorable pulmonary artery development.
Abstract:
The Blalock-Taussig shunt has been used at our institution in 64 infants with cyanotic congenital heart disease who required palliation. Thirty-one of these children were less than 2 months of age at the time of operation. There were no early shunt closures. There were two hospital deaths (3%). There was only one hospital death in the 31 patients less than 60 days old. According to a life-table analysis, 87% +/- 9% (+/- 95% confidence limits) of the shunts were functioning at 1 year and 78% +/- 12% at 2 years. Results are similar in the subgroup of children less than 60 days of age at the time of operation or in the subgroup of children weighing less than 3,999 gm at operation. In infants with small pulmonary arteries, pulmonary arterial growth was excellent (ipsilateral pulmonary artery/descending aorta ratio 0.70 leads to 0.95 in 550 days, p less than 0.001; contralateral ratio 0.73 leads to 0.99 in 550 days, p less than 0.001). The Blalock-Taussig shunt can be performed with low risk, provides excellent palliation, and is associated with excellent pulmonary artery growth.