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The Journal of Thoracic and Cardiovascular Surgery, Vol 81, 112-119, Copyright © 1981 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
MR de Leval, R McKay, M Jones, J Stark and FJ Macartney
Between April, 1975, and December, 1979, 99 modified Blalock-Taussig shunts
(MBTSs) were carried out at The Hospital for Sick Children, Great Ormond
Street. The operation consists of interposing between the subclavian artery
and the pulmonary artery a prosthesis of greater diameter than that of the
subclavian artery. The first 13 operations were performed with a prosthesis
of woven Dacron. Conduits of expanded polytetrafluorethylene (PTFE) were
used for 86 MBTSs, and these form the basis of this report. Forty-four
(51.1%) shunts were performed in infancy, 25 in patients under the age of 1
month (29.0%). Prostheses of 4 mm were used in 34 cases, 5 mm in 14, and 6
mm in 38. There were five shunt failures (5.8%) documented at postmortem or
angiocardiographic investigation. Including two late deaths for which
postmortem examinations were not obtained, the overall failure rate was
8.1% (seven patients). All these patients were operated upon in infancy,
four of them in the neonatal period. Although a longer follow-up is
necessary to assess the validity of these shunts, the early results are
encouraging. We believe we can now recommend MBTS as an alternative when
the classical Blalock-Taussig shunt is considered unsuitable.
ARTICLES
Modified Blalock-Taussig shunt. Use of subclavian artery orifice as flow regulator in prosthetic systemic-pulmonary artery shunts
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