Skip to main content
NCBI home page
The Texas Heart Institute Journal logoLink to The Texas Heart Institute Journal
. 1985 Mar;12(1):65–71.

Modified Blalock-Taussig Shunt with an Umbilical Vein Graft

Luiz Eduardo V Leão 1, José Carlos S Andrade 1, José Ernesto Succi 1, Clotario C Cueva 1, Expedito E Ribeiro 1, Antonio Carlos C Carvalho 1, Enio Buffolo 1
PMCID: PMC341796  PMID: 15227043

Abstract

We describe a modification of the Blalock Taussig anastomosis, with the interposition of a glutaraldehyde-tanned umbilical vein graft between the subclavian and pulmonary arteries. This operation was performed in 64 children: 11 were less than 1 month of age (17.2%), and 23 were between 1 and 6 months of age (34.9%). Hospital deaths occurred in six patients—all less than 6 months of age (9.4%). There was no instance of shunt occlusion noted. The clinical course was uneventful among survivors, except for one patient who died of endocarditis in the late postoperative follow-up.

The shunt procedure may be performed very rapidly, with minimal dissection, allowing the use of a graft larger than the diameter of the subclavian artery. This modification of the Blalock Taussig operation compares favorably with our previous experience with other shunt procedures and may be considered a valuable alternative in the palliative surgical treatment of several malformations with severe pulmonary oligemia.

Full text

PDF
65

Images in this article

68Image
on p.68
69Image
on p.69

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Barratt-Boyes B. G., Neutze J. M. Primary repair of tetralogy of Fallot in infancy using profound hypothermia with circulatory arrest and limited cardiopulmonary bypass: a comparison with conventional two stage management. Ann Surg. 1973 Oct;178(4):406–411. doi: 10.1097/00000658-197310000-00003. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Castaneda A. R., Freed M. D., Williams R. G., Norwood W. I. Repair of tetralogy of Fallot in infancy. Early and late results. J Thorac Cardiovasc Surg. 1977 Sep;74(3):372–381. [PubMed] [Google Scholar]
  3. Chopra P. S., Levy J. M., Dacumos G. C., Jr, Berkoff H. A., Loring L. L., Kahn D. R. The Blalock-Taussig operation: the procedure of choice in the hypoxic infant with tetralogy of Fallot. Ann Thorac Surg. 1976 Sep;22(3):235–238. doi: 10.1016/s0003-4975(10)64908-9. [DOI] [PubMed] [Google Scholar]
  4. Dardik H., Ibrahim I. M., Baier R., Sprayregen S., Levy M., Dardik I. I. Human umbilical cord. A new source for vascular prosthesis. JAMA. 1976 Dec 20;236(25):2859–2862. doi: 10.1001/jama.236.25.2859. [DOI] [PubMed] [Google Scholar]
  5. Dardik H., Ibrahim I. M., Dardik I. Evaluation of glutaraldehyde-tanned human umbilical cord vein as a vascular prosthesis for bypass to the popliteal, tibial, and peroneal arteries. Surgery. 1978 May;83(5):577–588. [PubMed] [Google Scholar]
  6. Feteih W., Rao P. S., Whisennand H. H., Mardini M. K., Lawrie G. M. Chylopericardium: new complication of blalock-taussig anastomosis. J Thorac Cardiovasc Surg. 1983 May;85(5):791–794. [PubMed] [Google Scholar]
  7. Gazzaniga A. B., Elliott M. P., Sperling D. R., Dietrick W. R., Eiseman J. T., McRae D. M., Bartlett R. H. Microporous expanded polytetrafluoroethylene arterial prosthesis for construction of aortopulmonary shunts: experimental and clinical results. Ann Thorac Surg. 1976 Apr;21(4):322–327. doi: 10.1016/s0003-4975(10)64320-2. [DOI] [PubMed] [Google Scholar]
  8. Guyton R. A., Owens J. E., Waumett J. D., Dooley K. J., Hatcher C. R., Jr, Williams W. H. The Blalock-Taussig shunt. Low risk, effective palliation, and pulmonary artery growth. J Thorac Cardiovasc Surg. 1983 Jun;85(6):917–922. [PubMed] [Google Scholar]
  9. KLINNER W., PASINI M., SCHAUDIG A. [Anastomosis between systemic and pulmonary arteries with the aid of plastic prostheses in cyanotic heart diseases]. Thoraxchirurgie. 1962 Jul;10:68–75. doi: 10.1055/s-0028-1096482. [DOI] [PubMed] [Google Scholar]
  10. Kirklin J. W., Blackstone E. H., Pacifico A. D., Brown R. N., Bargeron L. M., Jr Routine primary repair vs two-stage repair of tetralogy of Fallot. Circulation. 1979 Aug;60(2):373–386. doi: 10.1161/01.cir.60.2.373. [DOI] [PubMed] [Google Scholar]
  11. LEPERE R. H., KOHLER C. M., MORGAN B. C., KLINGER P. Plastic prostheses in systemic-pulmonary artery shunts. JAMA. 1963 Jan 26;183:283–285. doi: 10.1001/jama.1963.63700040037018a. [DOI] [PubMed] [Google Scholar]
  12. Laks H., Castaneda A. R. Subclavian arterioplasty for the ipsilateral Blalock-Taussig shunt. Ann Thorac Surg. 1975 Mar;19(3):319–321. doi: 10.1016/s0003-4975(10)64025-8. [DOI] [PubMed] [Google Scholar]
  13. Laks H., Fagan L., Barner H. B., Willman V. L. The Blalock-Taussig shunt in the neonate. Ann Thorac Surg. 1978 Mar;25(3):220–224. doi: 10.1016/s0003-4975(10)63526-6. [DOI] [PubMed] [Google Scholar]
  14. Lamberti J. J., Campbell C., Replogle R. L., Anagnostopoulos C., Lin C. Y., Chiemmongkoltip P., Arcilla R. The prosthetic (Teflon) central aortopulmonary shunt for cyanotic infants less than three weeks old: results and long-term follow-up. Ann Thorac Surg. 1979 Dec;28(6):568–577. doi: 10.1016/s0003-4975(10)63179-7. [DOI] [PubMed] [Google Scholar]
  15. REDO S. F., ECKER R. R. INTRAPERICARDIAL AORTICO-PULMONARY ARTERY SHUNT. Circulation. 1963 Oct;28:520–524. doi: 10.1161/01.cir.28.4.520. [DOI] [PubMed] [Google Scholar]
  16. SHUMACKER H. B., Jr, MANDELBAUM I. Ascending aorticpulmonary artery shunts in cyanotic heart disease. Surgery. 1962 Oct;52:675–678. [PubMed] [Google Scholar]
  17. Somerville J., Barbosa R., Ross D., Olsen E. Problems with radical corrective surgery after ascending aorta to right pulmonary artery shunt (Waterston's anastomosis) for cyanotic congenital heart disease. Br Heart J. 1975 Nov;37(11):1105–1112. doi: 10.1136/hrt.37.11.1105. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Todd P. J., Dangerfield P. H., Hamilton D. I., Wilkinson J. L. Late effects on the left upper limb of subclavian flap aortoplasty. J Thorac Cardiovasc Surg. 1983 May;85(5):678–681. [PubMed] [Google Scholar]
  19. WATERSTON D. J. [Treatment of Fallot's tetralogy in children under 1 year of age]. Rozhl Chir. 1962 Mar;41:181–183. [PubMed] [Google Scholar]
  20. de Leval M. R., McKay R., Jones M., Stark J., Macartney F. J. Modified Blalock-Taussig shunt. Use of subclavian artery orifice as flow regulator in prosthetic systemic-pulmonary artery shunts. J Thorac Cardiovasc Surg. 1981 Jan;81(1):112–119. [PubMed] [Google Scholar]

Articles from Texas Heart Institute Journal are provided here courtesy of Texas Heart Institute

RESOURCES