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Patency and development of stenosis in modified Blalock-Taussig shunts constructed using expanded polytetrafluoroethylene

Published online by Cambridge University Press:  19 August 2008

François Godart ,
Shakeel A. Qureshi ,
Ary Simha ,
Nuala Fagg ,
Philip B. Deverall ,
David Anderson ,
Edward Baker  and
Michael Tynan
François Godart
Affiliation:
Department of Paediatric Cardiology, Guy's Hospital, St Thomas Street, London SE1 9RT, United Kingdom
Shakeel A. Qureshi*
Affiliation:
Department of Paediatric Cardiology, Guy's Hospital, St Thomas Street, London SE1 9RT, United Kingdom
Ary Simha
Affiliation:
Department of Paediatric Cardiology, Guy's Hospital, St Thomas Street, London SE1 9RT, United Kingdom
Nuala Fagg
Affiliation:
Department of Paediatric Cardiology, Guy's Hospital, St Thomas Street, London SE1 9RT, United Kingdom
Philip B. Deverall
Affiliation:
Department of Paediatric Cardiology, Guy's Hospital, St Thomas Street, London SE1 9RT, United Kingdom
David Anderson
Affiliation:
Department of Paediatric Cardiology, Guy's Hospital, St Thomas Street, London SE1 9RT, United Kingdom
Edward Baker
Affiliation:
Department of Paediatric Cardiology, Guy's Hospital, St Thomas Street, London SE1 9RT, United Kingdom
Michael Tynan
Affiliation:
Department of Paediatric Cardiology, Guy's Hospital, St Thomas Street, London SE1 9RT, United Kingdom
*
Dr S.A. Qureshi, Department of Paediatric Cardiology, Guys Hospital, St Thomas Street, London SE1 9RT, United Kingdom. Tel: 0171 955 4616; Fax: 0171 955 4614.
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Abstract

Construction of a modified Blalock-Taussig shunt using polytetrafluroethylene is frequently used for palliation in infants with complex cyanotic heart disease. This study was performed to assess angiographically the late patency rate of such prosthetic shunts. A modified Blalock-Taussig shunt had been constructed in 82 children and, of these, 63 (77%) patients had post-operative angiography and were included in this study. There were 29 males and 34 females, ranging in age from 1 day to 164 months. A second shunt was needed in 7 patients. Thus, 70 shunts were studied. Of the shunts, 16 were 4 mm in diameter, 28 shunts 5 mm in diameter, and 26 shunts 6 mm in diameter. Postoperative angiography was performed on 1 day to 132 months (median 39 months) after construction of the shunts. Acute post operative occlusion occurred in 2(3%) patients, who had 5 and 6 mm shunts, respectively. At the latest follow-up (median 39 ± 26 months), 6(9%) late occlusions were noticed. Overall patency was 89% for all the shunts, with 94% of the 4 mm shunts, 85% of the 5 mm and 88% of the 6 mm shunts being patent. Regression analysis showed a progressive reduction in diameter of the graft with time. This narrowing of the graft may have been related to the formation of a ‘neointima’ due to fibrous hyperplasia.

Keywords

Modified Blalock-Taussig shuntsneointima
Type
Original Articles
Information
Cardiology in the Young , Volume 7 , Issue 2 , April 1997 , pp. 153 - 159
Copyright
Copyright © Cambridge University Press 1997

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