title: Modified Blalock-Taussig shunt with an umbilical vein graft.
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.
authors.affiliation: Division of Thoracic Surgery Department of Surgery, São Paulo Hospital Paulista School of Medicine, São Paulo, Brazil.
authors.forename: L E
authors.initials: LE
authors.lastname: Leão
authors.forename: J C
authors.initials: JC
authors.lastname: Andrade
authors.forename: J E
authors.initials: JE
authors.lastname: Succi
authors.forename: C C
authors.initials: CC
authors.lastname: Cueva
authors.forename: E E
authors.initials: EE
authors.lastname: Ribeiro
authors.forename: A C
authors.initials: AC
authors.lastname: Carvalho
authors.forename: E
authors.initials: E
authors.lastname: Buffolo