Reappearance of a Blalock anastomotic murmur after treatment for bacterial endocarditis

Abstract

S I N c E 1944, surgical creation of a subclavian to pulmonary artery anastomosis (Blalock operation) has been performed for tetralogy of Fallot and other cyanotic congenital heart conditions? Complications of such an operation have included operative death, progressive cardiac enlargement and failure, bacterial endocarditis, and late closure of the anastomosisY Loss of patency after an initial successful anastomosis usually is related to endothelization or thrombosis of the anastomotic site..A less commonly suspected cause of obstruction is bacterial endarteritis. This report describes the loss of a Blalock anastomotic murmur in a 15-year-old boy 12 years after cardiovascular operation. After diagnosis and therapy of bacterial endocarditis, the anastomotic murmur again became easily audible with concomitant evidence of increased pulmonary blood flow.