Modifed Blalock-Taussig Shunts for Patients with Congenital Heart Diseases of Diminutive Pulmonary Blood_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

XUZhao-Jun ¹ ,  SONGLan ² , YINXiao-Qing ¹ , WANGZhao-li ¹ , YANGJin ¹ , CHENGYu ¹ , XIEXin-long ¹ , ZHANGSheng-kang ¹ , HUANGWen-juan ¹

1. Department of Cardiothoracic Surgery, te First Afliated Hospital, Hunan University of Chinese Medicine, Changsha 410007, P. R. China;
2. Department of Biochemistry and Molecular Biology, Hunan University of Chinese Medicine, Changsha 410208, P. R. China;

Corresponding author：

SONGLan, Email: songlan311492@163.com

Keywords：

Modified Blalock-Taussig shunts; Congenital heart diseases; Palliative operation

DOI：

10.7507/1007-4848.20150118

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To evaluate the surgical outcomes of modified Blalock-Taussig shunts in the patients with congenital heart diseases of diminutive pulmonary blood. Methods We retrospectively analyzed the clinical data of 39 patients with congenital heart diseases of diminutive pulmonary blood, who underwent modified Blalock-Taussig shunts with Gore-Tex vessels in the First Affiliated Hospital, Hunan University of Chinese Medicine between June 2007 and June 2013. There were 23 male and 16 female patients at age of 6 months to 16 years (4.64±3.85) years, body weigh at 4.5-43.0 (14.81±8.69) kg. Results There were 4 postoperative deaths. The early mortality was 7.69% (3/39). The arterial oxygen saturation increased from 64.28%±8.05% to 81.07%±5.76% (P < 0.01). Ideal pulmonary flow in each patient was obtained. Pulmonary arteries were significantly improved compared with those before operation. McGoon ratio (1.11±0.16 versus 1.58±0.22, P < 0.01) and Nakata index (113.98±14.84 mm²/m² versus 160.98±26.65 mm²/m², P < 0.01) increased with a statistical difference. Two-stage radical operations were performed in 8 patients. Conclusions Modified Blalock-Taussig shunt is effective in promoting development of the pulmonary arteries and improving cyanosis significantly. Modified Blalock-Taussig shunt can correct hypoxia to prepare for the radical operation．

Citation： XUZhao-Jun, SONGLan, YINXiao-Qing, WANGZhao-li, YANGJin, CHENGYu, XIEXin-long, ZHANGSheng-kang, HUANGWen-juan. Modifed Blalock-Taussig Shunts for Patients with Congenital Heart Diseases of Diminutive Pulmonary Blood. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2015, 22(5): 450-453. doi: 10.7507/1007-4848.20150118 Copy

1.	肖海波, 梅举, 丁宝芳, 等.改良Blalock-Taussig分流术治疗复杂发绀型先天性心脏病的效果.实用儿科临床杂志, 2011, 26(1):19-21.
2.	周诚, 董念国, 杜心灵, 等.姑息性手术在复杂先天性心脏病患者中的应用.中国胸心血管外科临床杂志, 2012, 19(5):494-497.
3.	汪曾炜, 刘维永, 张宝仁, 主编.心脏外科学.北京:人民军医出版社, 2003:878-939.
4.	O'Connor MJ, Ravishankar C, Ballweg JA, et al. Early systemic-topulmonary artery shunt intervention in neonates with congenital heart disease. J Torac Cardiovasc Surg, 2011, 142(1):106-112.
5.	刘金平, 董念国, 孙宗全, 等.非体外循环下复杂先天性心脏病的姑息手术.临床心血管病杂志, 2010, 26(5):770-772.
6.	郑景浩, 刘锦纷, 苏肇伉, 等.体肺分流术在小儿复杂先天性心脏病手术中的应用.中华胸心血管外科杂志, 2005, 12(6):371.
7.	Fenton KN, Siewers RD, Rebovich B, et al. Interim mortality in infants with systemic-to-pulmonary artery shunts. Ann Thorac Surg, 2003, 76(1):152-157.
8.	方敏华, 王辉山, 汪曾炜, 等.体-肺动脉分流术后早期分流失效的危险因素分析.中国胸心血管外科临床杂志, 2012, 19(4):354-357.
9.	徐卓明, 杨琦, 郭林林, 等.先天性心脏病体肺分流术后早期失败危险因素分析.上海交通大学学报(医学版), 2011, 31(9):1266-1268.
10.	Gedicke M, Morgan G, Parry A, et al. Risk factors for acute shunt blockage in children afer modified Blalock-Taussig shunt operations. Heart Vessels, 2010, 25(5):405-409.
11.	Petrucci O, O'Brien SM, Jacobs ML, et al. Risk factors for mortality and morbidity afer the neonatal Blalock-Taussig shunt procedure. Ann Torac Surg, 2011, 92(2):642-651.
12.	Sahoo TK, Chauhan S, Sahu M, et al. Effects of hemodilution on outcome after modified Blalock-Taussig shunt operation in children with cyanotic congenital heart disease. J Cardiothorac Vasc Anesth, 2007, 21(2):179-183.
13.	Li JS, Yow E, Berezny KY, et al. Clinical outcomes of palliative surgery including a systemic-to-pulmonary artery shunt in infants with cyanotic congenital heart disease:does aspirin make a difference? Circulation, 2007, 116(3):293-297.
14.	郭林林, 杨琦, 徐卓明, 等.先天性心脏病体肺分流术的疗效评估.中华临床医师杂志(电子版), 2012, 6(4):52-55.
15.	Amark KM, Karamlou T, O'Carroll A, et al. Independent factors associated with mortality, reintervention, and achievement of complete repair in children with pulmonary atresia with ventricular septal defect. J Am Coll Cardiol, 2006, 47(7):1448-1456.
16.	邓喜成, 沈向东, 郭少先, 等.姑息手术在肺动脉闭锁合并室间隔缺损分期矫治中的应用.中国胸心血管外科临床杂志, 2011, 18(2):104-108.
17.	Seipelt RG, Vazquez-Jimenez JF, Sachweh JS, et al. Antegrade palliation for diminutive pulmonary arteries in Tetralogy of Fallot. Eur J Cardiothorac Surg, 2002, 21(4):721-724.
18.	Kim HK, Kim WH, Kim SC, et al. Surgical strategy for pulmonary coaretation in the univentrieular heart. Eur J Cardiothorac Surg, 2006, 29(1):100-104.

1. 肖海波, 梅举, 丁宝芳, 等.改良Blalock-Taussig分流术治疗复杂发绀型先天性心脏病的效果.实用儿科临床杂志, 2011, 26(1):19-21.
2. 周诚, 董念国, 杜心灵, 等.姑息性手术在复杂先天性心脏病患者中的应用.中国胸心血管外科临床杂志, 2012, 19(5):494-497.
3. 汪曾炜, 刘维永, 张宝仁, 主编.心脏外科学.北京:人民军医出版社, 2003:878-939.
4. O'Connor MJ, Ravishankar C, Ballweg JA, et al. Early systemic-topulmonary artery shunt intervention in neonates with congenital heart disease. J Torac Cardiovasc Surg, 2011, 142(1):106-112.
5. 刘金平, 董念国, 孙宗全, 等.非体外循环下复杂先天性心脏病的姑息手术.临床心血管病杂志, 2010, 26(5):770-772.
6. 郑景浩, 刘锦纷, 苏肇伉, 等.体肺分流术在小儿复杂先天性心脏病手术中的应用.中华胸心血管外科杂志, 2005, 12(6):371.
7. Fenton KN, Siewers RD, Rebovich B, et al. Interim mortality in infants with systemic-to-pulmonary artery shunts. Ann Thorac Surg, 2003, 76(1):152-157.
8. 方敏华, 王辉山, 汪曾炜, 等.体-肺动脉分流术后早期分流失效的危险因素分析.中国胸心血管外科临床杂志, 2012, 19(4):354-357.
9. 徐卓明, 杨琦, 郭林林, 等.先天性心脏病体肺分流术后早期失败危险因素分析.上海交通大学学报(医学版), 2011, 31(9):1266-1268.
10. Gedicke M, Morgan G, Parry A, et al. Risk factors for acute shunt blockage in children afer modified Blalock-Taussig shunt operations. Heart Vessels, 2010, 25(5):405-409.
11. Petrucci O, O'Brien SM, Jacobs ML, et al. Risk factors for mortality and morbidity afer the neonatal Blalock-Taussig shunt procedure. Ann Torac Surg, 2011, 92(2):642-651.
12. Sahoo TK, Chauhan S, Sahu M, et al. Effects of hemodilution on outcome after modified Blalock-Taussig shunt operation in children with cyanotic congenital heart disease. J Cardiothorac Vasc Anesth, 2007, 21(2):179-183.
13. Li JS, Yow E, Berezny KY, et al. Clinical outcomes of palliative surgery including a systemic-to-pulmonary artery shunt in infants with cyanotic congenital heart disease:does aspirin make a difference? Circulation, 2007, 116(3):293-297.
14. 郭林林, 杨琦, 徐卓明, 等.先天性心脏病体肺分流术的疗效评估.中华临床医师杂志(电子版), 2012, 6(4):52-55.
15. Amark KM, Karamlou T, O'Carroll A, et al. Independent factors associated with mortality, reintervention, and achievement of complete repair in children with pulmonary atresia with ventricular septal defect. J Am Coll Cardiol, 2006, 47(7):1448-1456.
16. 邓喜成, 沈向东, 郭少先, 等.姑息手术在肺动脉闭锁合并室间隔缺损分期矫治中的应用.中国胸心血管外科临床杂志, 2011, 18(2):104-108.
17. Seipelt RG, Vazquez-Jimenez JF, Sachweh JS, et al. Antegrade palliation for diminutive pulmonary arteries in Tetralogy of Fallot. Eur J Cardiothorac Surg, 2002, 21(4):721-724.
18. Kim HK, Kim WH, Kim SC, et al. Surgical strategy for pulmonary coaretation in the univentrieular heart. Eur J Cardiothorac Surg, 2006, 29(1):100-104.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Modifed Blalock-Taussig Shunts for Patients with Congenital Heart Diseases of Diminutive Pulmonary Blood

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