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Ann Thorac Surg 1984;38:26-30
© 1984 The Society of Thoracic Surgeons

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Articles

A Comparison of Blalock-Taussig, Waterston, and Polytetrafluoroethylene Shunts in Children Less Than Two Weeks of Age

Departments of Cardiology and Cardiothoracic Surgery, Children's Hospital of Philadelphia, Philadelphia, PA, The Johns Hopkins Hospital, Baltimore, MD, and State University, Groningen, The Netherlands

Accepted for publication January 13, 1984.

^* Address reprint requests to Dr. Stephenson, Children's Hospital of Philadelphia, 34th St and Civic Center Blvd, Philadelphia, PA 19104

Results obtained with Blalock-Taussig, Waterston, and polytetrafluoroethylene (PTFE) shunts were compared in 67 cyanotic infants less than 2 weeks of age. A different shunt was preferably used at each of three institutions. The incidences of early shunt failure (3 out of 21, 14%), mortality after revision of early shunt failure (0 out of 3), and overall hospital mortality (1 out of 21, 5%) were all lowest for the PTFE shunt. Incidence of congestive heart failure secondary to excessive flow was comparable for the Blalock-Taussig and PTFE shunts, both of which were lower than the Waterston shunt. Cumulative probabilities of late shunt adequacy were calculated for hospital survivors. At 1 year, all shunts provided comparable adequate palliation (greater than 80%). Probability of late shunt failure was significantly higher (p = 0.04) for the PTFE shunt at 3.5 years. Results suggest that the PTFE shunt may be the safest and most effective shunt in neonates, but that elective shunt replacement or total repair may be warranted in the first or second year of life.

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