[Long-term patency after the Blalock-Taussig operation--comparison between classic and modified shunts]

There is still a need for Blalock-Taussig shunt (BTS) in some situations involving complex heart diseases. This study demonstrates the long-term patency after shunt procedure in classic and modified BTS of different calibers using cineangiographic evaluation. Between January 1980 and December 1994, 150 patients 236 BTS including classic BTS (cBTS) in 62, modified in 174 procedures (GS: Golaski microknit graft in 112, EPTFE: expanded polytetrafluoroethylene graft in 62). Cineangiographic Evaluation for graft patency and freedom from stenosis (less than 50% in diameter) was performed a mean interval of 35 months after BTS. The five-year patency of cBTS was significantly superior to that of mBTS (EPTFE, p < 0.001). There was a significant superiority of three-year actuarial freedom from graft stenosis in cBTS compared to that after mBTS with GS (p < 0.01) and in mBTS with EPTFE compared to mBTS with GS (p < 0.05). In cases receiving small caliber grafts (4 mm or less), cBTS showed significantly better patency after five years compared to mBTS with GS (p < 0.05) and showed significant advantages in three-year actuarial freedom from graft stenosis compared to that after mBTS (p < 0.05). This study demonstrated the superior patency and freedom from stenosis after cBTS compared to that after mBTS, especially in cases receiving GS grafts. MBTS with GS graft and with small caliber EPTFE grafts could not be expected to maintain freedom from stenosis for three years.