Modifiedversus classical blalock-taussig shunts for congenital cyanotic heart diseases: A comparison of long-term results

Abstract

Between March 1977 and December 1984, 103 Blalock-Taussig shunts were performed on 88 patients. Included in this study were 40 patients who underwent the modified BT shunt and 63 patients who underwent the classical BT shunt. 13 of the modified BT shunts (33 per cent) and 18 of the classical BT shunts (29 per cent) were performed during infancy and 10 of the modified BT shunts (25 per cent) were performed on patients under the age of 3 months. EPTFE grafts of varying sizes were used in the patients who underwent modified BT shunts--4 mm in 14 cases, 5 mm in 15 cases and 6 mm in 11 cases, respectively. The early mortality rate was 11 per cent (3 deaths) in the group who had modified BT shunts and 8 per cent (5 deaths) in the group who had classical BT shunts. Over a follow-up period of 6 years, 6 shunt failures were diagnosed in the modified BTS group by auscultation and/or angiographic study, and during a follow-up period of 8 years, 12 shunt failures were diagnosed in the classical BTS group. The patency rate 3 years after surgery was 88.8 per cent in the modified BTS group and 78.0 per cent in the classical BTS group. The patency rate 5 years after surgery was 88.8 per cent in the modified BTS group and 75 per cent in the classical BTS group.(ABSTRACT TRUNCATED AT 250 WORDS)

The Blalock-Taussig Shunt

“…Two‐dimensional echocardiography may eliminate the need for invasive investigation in selected patients undergoing a B‐T shunt. Reitman et al 53 first reported using echocardiography to prove the patency of a systemic‐to‐pulmonary artery anastomosis. They noted a close correlation between the left atrium‐to‐aortic ratio and the clinical manifestation of congestive heart failure, and suggested that an increase in the left atrial size represents an increase in pulmonary blood flow.…”