Modified Blalock-Taussig Shunt: A Single-Center Experience and Follow-Up.

Abstract

The modified Blalock-Taussig shunt (MBTS) is used to palliate patients with restrictive pulmonary blood flow in complex cardiac anomalies. We describe the immediate and follow-up results of patients with MBTS in our center. Patients who received MBTS (excluding those with hypoplastic left heart syndrome) from May 2008 to December 2018 were retrospectively identified. Hospital records were evaluated to determine patient demographics, diagnoses, and perioperative data. Patients were followed up by echocardiograph to evaluate the patency of the graft until stage II procedure or death. MBTS was performed in 25 patients by 2 surgeons; 16% were neonates, and 60% had pulmonary atresia and 24% tetralogy of Fallot. The patients' median age was 2.6 months (range 0.2 to 372), and median weight was 5.3 kg (range 1.9 to 45). Preoperative oxygen saturation (SaO2) was 68.7% ± 7.8%. Forty-eight percent of patients received a 3.5-mm graft, and 20% received a concomitant pulmonary arterioplasty with cardiopulmonary bypass. Postoperative SaO2 was 83.2% ± 3.6%, significantly different from preoperative SaO2 (P < .05). Follow-up duration was 1.2 years (range 0.3 to 7.8), with no graft blockage. Three patients died in hospital from cardiorespiratory decompensation after MBTS with concomitant pulmonary arterioplasty. The median age of patients receiving a stage II procedure was 1 year (range 0.4 to 17.4). Actuarial 1-year survival was 79.7% (95% confidence interval 53.1% to 92.2%). MBTS continues to be valuable for palliation of complicated cyanotic congenital heart disease, yet mortality was considerable with concomitant pulmonary arterioplasty. With effective coagulation, the patency rate of grafts was high.