title: A comparison of the modified Blalock-Taussig shunt with the right ventricle-to-pulmonary artery conduit.
abstract: BACKGROUND
  This study compared the modified Blalock-Taussig (MBT) shunt with the right ventricle-to-pulmonary artery (RVPA) conduit with respect to outcome and PA growth.
  
  
  METHODS
  PA growth was assessed in 19 MBT patients and in 15 RVPA patients before stage 2 palliation for hypoplastic left heart syndrome. The RVPA was done with a ringed Gore-Tex tube (W. L. Gore and Assoc, Flagstaff, AZ) at each anastomosis.
  
  
  RESULTS
  The two cohorts had similar pre-Glenn demographic and hemodynamic data. No patient required transcatheter or surgical intervention on the shunt or PAs after stage 1 palliation. The branch PA growth was better in RVPA (McGoon ratio: MBT, 1.5±0.2 vs RVPA, 2.0±0.6; p<0.003) and was significantly more balanced (right-to-left PA area ratio: MBT, 1.5±0.5 vs RVPA, 0.9±0.6; p=0.002). The Nakata index trended higher in RVPA (MBT, 242A±90 mm2/m2 vs RVPA, 267±95 mm2/m2, p=0.2). After stage 2 palliation, oxygen saturation trended higher in the RVPA (81%±5%) vs MBT cohort (77%±8%, p<0.08).
  
  
  CONCLUSIONS
  The Norwood operation using a RVPA nonvalved conduit is associated with improved branch PA growth.
authors.affiliation: Department of Pediatric Cardiac Surgery, Cardinal Glennon Children's Hospital, St. Louis University School of Medicine, St. Louis, Missouri 63104, USA. fiorem2@slu.edu
authors.forename: Andrew C
authors.initials: AC
authors.lastname: Fiore
authors.forename: Courtney
authors.initials: C
authors.lastname: Tobin
authors.forename: Saadeh
authors.initials: S
authors.lastname: Jureidini
authors.forename: Mohammad
authors.initials: M
authors.lastname: Rahimi
authors.forename: Eric S
authors.initials: ES
authors.lastname: Kim
authors.forename: Kenneth
authors.initials: K
authors.lastname: Schowengerdt
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods; D058366:Blalock-Taussig Procedure / Q000379:methods* / Q000401:mortality; D015331:Cohort Studies; D018618:Echocardiography, Doppler, Color; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000601:surgery; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D018636:Hypoplastic Left Heart Syndrome / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay; D008297:Male; D058327:Norwood Procedures / Q000379:methods* / Q000401:mortality; D011138:Polytetrafluoroethylene; D011183:Postoperative Complications / Q000401:mortality / Q000503:physiopathology; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000254:growth & development* / Q000601:surgery; D011859:Radiography; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D011138:Polytetrafluoroethylene