Ann Thorac Surg 2010;89:311. doi:10.1016/j.athoracsur.2009.02.037
© 2010 The Society of Thoracic Surgeons
Images in Cardiothoracic Surgery
Classical Blalock-Taussig Shunt
Tomohiro Tsunekawa, MD,
Yuichi Ueda, MD*,
Akihiko Usui, MD,
Hideki Oshima, MD,
Atsuo Maekawa, MD,
Yoshimori Araki, MD
Department of Cardiothoracic Surgery, Nagoya University Graduate School of Medicine, Showa-ku, Nagoya, Aichi, Japan
* Address correspondence to Dr Ueda, Department of Cardiothoracic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, Aichi, 466-8550, Japan (Email: yueda{at}med.nagoya-u.ac.jp).
A 72-year-old woman presented with the chief complaint of shortness of breath. Her medical history included a diagnosis of tetralogy of Fallot with a right aortic arch and a status post–classical Blalock-Taussig shunt at 26 years of age in 1962. The cardiothoracic ratio was 84% on chest roentgenogram (Fig 1). The arterial oxygen saturation was 83%. Three-dimensional computed tomography scans (Figs 2 and 3)
exhibited a 46-year-long standing patent left subclavian artery to left pulmonary arterial shunt. The shunt was slightly dilated, with mild narrowing at the anastomosis (white arrow, Fig 2). The bilateral pulmonary arteries were well developed. The current diagnosis was congestive heart failure, and the symptoms improved after the administration of intravenous diuretics. Despite the recent incidence of congestive heart failure after conversion to atrial flutter, the patient's clinical history was otherwise unremarkable, with no evidence of stroke or infection; and the classical Blalock-Taussig shunt was thus found to have functioned well for more than 4 decades.
