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Ann Thorac Surg 1978;25:220-224
© 1978 The Society of Thoracic Surgeons

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Articles

The Blalock-Taussig Shunt in the Neonate

Department of Surgery and Pediatric Cardiology, St. Louis University School of Medicine, St. Louis, MO.

Accepted for publication September 6, 1977.

^* Address reprint requests to Dr. Laks, Department of Surgery, Yale University School of Medicine, 333 Cedar St, New Haven, CT 06510

With improvements in the techniques of microvascular surgery, the Blalock-Taussig shunt has been applied to smaller infants. We report our experience in 17 neonates (mean age 9 days, mean weight 3.2 kg) who underwent emergency shunt operations. The early mortality was 17.6% (3 of 17), with only 1 death (7%) from renal failure and sepsis, in the last 14 patients. Three shunts were patent but inadequate and required a secondary procedure, which was successful in all 3. There were 3 patients with late shunt failures at a mean of 15 months postoperatively, while 2 are still doing well at 15 and 18 months. No patients developed congestive cardiac failure. The late mortality was high (5 of 14), but was due to late shunt failure and was preventable in only 1 patient. These results are encouraging, and we continue to perform the Blalock-Taussig shunt in neonates. It is hoped that improvements in technique will reduce the incidence of inadequate shunts.

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