Growth of the Subclavian Artery and the Anastomosis in Blalock-Taussig Shunt: Absorbable Versus Nonabsorbable Suture

Abstract

Background. We evaluated the growth of Blalock-Taussig shunts placed with absorbable suture by cineangiographic findings and long-term results and compared them with those in an earlier group of patients in whom we used nonabsorbable suture. Methods. Eighty-one patients had postoperative cineangiography 1 year or more after a Blalock-Taussig shunt procedure. From September 1985 to December 1994, 40 patients (group I) underwent a Blalock-Taussig shunt procedure with the use of absorbable polydioxanone suture, and from January 1980 to August 1989, 41 (group II) underwent the same operation with nonabsorbable polypropylene suture. Cineangiograms were reviewed to assess shunt patency and growth of the subclavian arteries and the subclavian artery–pulmonary artery anastomoses. Results. At the Blalock-Taussig shunt operation, mean outer diameters of the subclavian artery and the anastomosis in group I were 3.8 ± 0.1 mm and 4.1 ± 0.1 mm, respectively and 3.9 ± 0.1 mm and 4.0 ± 0.1 mm in group II. The mean inner diameters of the subclavian artery and the anastomosis measured in postoperative cineangiograms were 7.9 ± 0.5 mm and 4.6 ± 0.2 mm, respectively in group I and 6.6 ± 0.4 mm and 3.1 ± 0.2 mm in group II. The diameters of both the subclavian artery ( p < 0.05) and the anastomosis ( p < 0.001) were significantly greater in group I than in group II. Five years after operation, 71.1% ± 7.4% of patients in group I and 54.8% ± 8.0% in group II had good palliation. Conclusions. The use of absorbable polydioxanone suture has an advantage in terms of growth of the diameters of the subclavian artery and the anastomosis in a Blalock-Taussig shunt and may improve the long-term results after this shunt operation in infancy.