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Stenting of modified and classical Blalock–Taussig shunts – lessons learned from seven consecutive cases

Published online by Cambridge University Press:  17 March 2011

Thomas Krasemann*
Affiliation:
Department of Paediatric Cardiology, Evelina Children's Hospital, Guy's & St Thomas’ NHS Foundation Trust, London, United Kingdom
Aphrodite Tzifa
Affiliation:
Department of Paediatric Cardiology, Evelina Children's Hospital, Guy's & St Thomas’ NHS Foundation Trust, London, United Kingdom
Eric Rosenthal
Affiliation:
Department of Paediatric Cardiology, Evelina Children's Hospital, Guy's & St Thomas’ NHS Foundation Trust, London, United Kingdom
Shakeel A. Qureshi
Affiliation:
Department of Paediatric Cardiology, Evelina Children's Hospital, Guy's & St Thomas’ NHS Foundation Trust, London, United Kingdom
*
Correspondence to: T. Krasemann, Department of Paediatric Cardiology, Evelina Children's Hospital, Guy's & St Thomas’ NHS Foundation Trust, Westminster Bridge Road, London SE1 7EH, United Kingdom. Tel: 44 207 1884562; Fax: 44 207 1884556; E-mail: [email protected]

Abstract

In neonates and infants with a shunt-dependent pulmonary circulation, stenosis of the shunt needs to be treated aggressively to prevent a fatal outcome. We report the technique and outcome in seven consecutive neonates and infants with Blalock–Taussig shunt stenosis, who were treated with intraluminal stents. Stenting of classical or modified Blalock–Taussig shunts is technically feasible and can be used as a rescue procedure. Neointimal dissection is less likely compared with balloon angioplasty of the shunt alone.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2011

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References

1.Blalock, A, Taussig, HB. Landmark article May 19, 1945: The surgical treatment of malformations of the heart in which there is pulmonary stenosis or pulmonary atresia. By Alfred Blalock and Helen B. Taussig. JAMA 1984; 251: 21232138.CrossRefGoogle Scholar
2.Gazzaniga, AB, Lamberti, JJ, Siewers, RD, et al. Arterial prosthesis of microporous expanded polytetrafluoroethylene for construction of aorta-pulmonary shunts. J Thorac Cardiovasc Surg 1976; 72: 357363.CrossRefGoogle ScholarPubMed
3.Klinner, W, Pasini, M, Schaudig, A. Anastomose zwischen System and Lungenarterie mit Hilfe von Kunstoffprothesen bei zyanotischen Herzvitien. Thoraxchirurgie 1962; 10: 6875.Google Scholar
4.Kaestner, M, Handke, RP, Photiadis, J, et al. Implantation of stents as an alternative to reoperation in neonates and infants with acute complications after surgical creation of a systemic-to-pulmonary arterial shunt. Cardiol Young 2008; 18: 177184.CrossRefGoogle ScholarPubMed
5.Peuster, M, Fink, C, Bertram, H, et al. Transcatheter recanalization and subsequent stent implantation for the treatment of early postoperative thrombosis of modified Blalock-Taussig shunts in two children. Cathet Cardiovasc Diagn 1998; 45: 405408.3.0.CO;2-A>CrossRefGoogle ScholarPubMed
6.Krasemann, T, Qureshi, S. Stenting of a stenosed modified Blalock Taussig shunt after Norwood-I palliation for hypoplastic left heart. Heart 2007; 93: 1509.CrossRefGoogle ScholarPubMed
7.Petit, CJ, Gillespie, MJ, Kreutzer, J, et al. Endovascular stents for relief of cyanosis in single-ventricle patients with shunt or conduit-dependent pulmonary blood flow. Catheter Cardiovasc Interv 2006; 68: 280286.CrossRefGoogle ScholarPubMed
8.Kouatli, A, Al Ata, J, Galal, MO, et al. Stent implantation to maintain patency of a stenosed Blalock Taussig shunt. Asian Cardiovasc Thorac Ann 2005; 13: 274276.CrossRefGoogle ScholarPubMed
9.Maree, A, Walsh, KP. Coronary stent insertion into a 20-year-old Blalock-Taussig Shunt. Ir Med J 2006; 99: 218.Google ScholarPubMed
10.Bader, R, Somerville, J, Redington, A. Use of self-expanding stents in stenotic aortopulmonary shunts in adults with complex cyanotic heart disease. Heart 1999; 82: 2729.CrossRefGoogle ScholarPubMed
11.Zahn, EM, Chang, AC, Aldousany, A, et al. Emergent stent placement for acute Blalock-Taussig shunt obstruction after stage 1 Norwood surgery. Cathet Cardiovasc Diagn 1997; 42: 191194.3.0.CO;2-Q>CrossRefGoogle ScholarPubMed