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The Annals of Thoracic Surgery, Vol 26, 38-41, Copyright © 1978 by The Society of Thoracic Surgeons
KR Tyson, AJ Larrieu and JT Kirchmer Jr
Many surgeons have been reluctant to perform Blalock shunts in patients who
are in infancy or early childhood (less than 24 months old) and have done
instead direct aortopulmonary anastomoses. Recently, others have advocated
complete repair of tetralogy of Fallot in early infancy because of the high
mortality of direct aortopulmonary shunts. We believe the Blalock-Taussig
anastomosis is a safe and effective palliative procedure for all infants
with inadequate pulmonary blood flow regardless of size. During the past
nine years, 24 babies less than 2 years old who were followed had
construction of Blalock-Taussig anastomosis for inadequate pulmonary blood
flow. There were no operative deaths and no shunt-related late deaths. Of
the 24 babies, 12 were less than 12 months old. Eighteen of the 24 had
tetralogy of Fallot. The remaining 6 had a variety of lesions with
inadequate pulmonary blood flow. The mean weight of the entire group was
7.3 +/- 1.6 kg. Of those infants less than 12 months old, the mean weight
was 6.8 +/- 2.0 kg. More than 6 months following construction of the shunt,
2 babies died from sepsis unrelated to cardiovascular status. All infants
had adequate but not excessive pulmonary blood flow after shunting. There
were no late shunt failures.
ARTICLES
The Blalock-Taussig shunt in the first two years of life: a safe and effective procedure
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