Blalock–Thomas–Taussig shunt

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Blalock–Thomas–Taussig shunt

The Blalock–Thomas–Taussig shunt (BT shunt) is a surgical procedure used to increase pulmonary blood flow for palliation in children with congenital heart defects that result in cyanosis. This procedure is named after Alfred Blalock, Vivien Thomas, and Helen B. Taussig, who collaborated in its development.

History

The BT shunt was first performed in 1944 at Johns Hopkins Hospital by Dr. Alfred Blalock and his assistant Vivien Thomas, based on the ideas of pediatric cardiologist Dr. Helen B. Taussig. This groundbreaking surgery was initially developed to treat tetralogy of Fallot, a congenital heart defect that includes four anatomical abnormalities.

Indications

The primary indication for a Blalock–Thomas–Taussig shunt is to provide palliation for cyanotic heart defects, particularly tetralogy of Fallot and other conditions where there is decreased pulmonary blood flow. It is often used as a temporary measure to improve oxygenation until a more definitive surgical repair can be performed.

Procedure

The BT shunt involves creating a connection between the subclavian artery and the pulmonary artery. This connection allows blood to flow from the systemic circulation into the pulmonary circulation, thereby increasing the amount of oxygenated blood available to the body. The procedure can be performed as a classic BT shunt, which uses the patient's own subclavian artery, or as a modified BT shunt, which uses a synthetic graft.

Classic BT Shunt

In the classic BT shunt, the subclavian artery is divided, and the distal end is connected to the pulmonary artery. This method was the original technique described by Blalock and Thomas.

Modified BT Shunt

The modified BT shunt uses a synthetic tube graft, typically made of polytetrafluoroethylene (PTFE), to connect the subclavian artery to the pulmonary artery. This modification allows for better control of the shunt size and reduces the risk of complications associated with the classic technique.

Complications

Complications of the BT shunt can include:

• Thrombosis of the shunt
• Infection
• Pulmonary hypertension
• Heart failure

Outcomes

The BT shunt has significantly improved the survival and quality of life for children with cyanotic heart defects. It serves as a bridge to more definitive surgical repairs, such as the complete repair of tetralogy of Fallot or other complex congenital heart surgeries.

Legacy

The development of the Blalock–Thomas–Taussig shunt marked a significant milestone in the field of pediatric cardiology and cardiothoracic surgery. It demonstrated the importance of collaboration between surgeons, cardiologists, and researchers in advancing medical science.

See also

• Tetralogy of Fallot
• Congenital heart defect
• Pediatric cardiology
• Cardiothoracic surgery