Modified Blalock-Taussig shunts: results in infants less than 3 months of age.
The optimal procedure for shunting palliation in cyanotic infants remains to be determined. Sixty-two infants less than 3 months of age underwent 63 modified Blalock-Taussig shunts. Their age range at operation was 1 to 84 days (mean, 16 +/- 20 days). Shunts were constructed using 5-mm polytetrafluorethylene tubes in 20 patients and 4-mm polytetrafluoroethylene grafts in 43 patients. There were 13 early deaths (21%; CL, 15% to 27%) of which three deaths (5%; confidence limits, 2% to 9%) were shunt related. The survivors were followed up from 6 to 53 months (mean, 29 +/- 12.5 months). Shunt failure (occlusion, inadequate palliation) occurred in 27 patients. The overall probability rate of adequate shunt function was 58% +/- 8% at 2 years. Univariate and multivariate analyses showed that the size of the graft was a risk factor of shunt failure. Severe distortion of the pulmonary arterial branch was noted in 12 patients. The inferences are: (1) modified Blalock-Taussig shunts provide satisfactory early palliation but late shunt failure is frequent; (2) similar results should be obtained with other shunting procedures; and (3) the optimal procedure should be selected for each cyanotic infant on an individual basis.
Tamisier
D
D
Service de Chirurgie Thoracique et Cardiovasculaire, Hôpital Laënnec, Paris, France.
Vouhé
P R
PR
Vernant
F
F
Lecá
F
F
Massot
C
C
Neveux
J Y
JY
D000714:Anastomosis, Surgical / Q000379:methods / Q000401:mortality; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D010166:Palliative Care / Q000379:methods*; D011651:Pulmonary Artery / Q000000981:diagnostic imaging; D011859:Radiography; D012086:Reoperation; D012307:Risk Factors; D015996:Survival Rate; D014654:Vascular Patency