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Ann Thorac Surg 1990;49:797-801
© 1990 The Society of Thoracic Surgeons
Service de Chirurgie Thoracique et Cardiovasculaire, Hôpital Laënnec, Paris, France
Accepted for publication January 9, 1990.
* Address reprint requests to Dr Vouhé, Hôpital Laënnec, 12, rue de Sèvres, 75340 Paris Cedex 07, France.
The optimal procedure for shunting palliation in cyanotic infants remains to be determined. Sixty-two infants less than 3 months of age underwent 33 modified Blalock-Taussig shunts. Their age range at operation was 1 to 84 days (mean, 16 ± 20 days). Shunts were constructed using 5-mm polytetrafluoroethylene tubes in 20 patients and 4-mm polytetrafluoroethylene grafts in 43 patients. There were 13 early deaths (21%: CL, 15% to 27%) of which three deaths (5%; confidence limits, 2% to 9%) were shunt related. The survivors were followed up from 6 to 53 months (mean, 29 ± 12.5 months). Shunt failure (occlusion, inadequate palliation) occurred in 27 patients. The overall probability rate of adequate shunt function was 58% ± 8% at 2 years. Univariate and multivariate analyses showed that the size of the graft was a risk factor of shunt failure. Severe distortion of the pulmonary arterial branch was noted in 12 patients. The inferences are: (1) modified Blalock-Taussig shunts provide satisfactory early palliation but late shunt failure is frequent; (2) similar results should be obtained with other shunting procedures; and (3) the optimal procedure should be selected for each cyanotic infant on an individual basis.
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