ObjectiveTo analyze the effect of modified B-T shunt for the treatment of complex congenital heart disease. MethodsWe retrospectively analyzed the clinical data of 150 B-T case times performed in 143 patients with complex congenital heart disease in Shanghai Xinhua Hospital between July 2006 and January 2013.There were 100 case times for male patients and 50 case times for female patients with age of 2-756 (20.17 ±80.37) months and weight of 4-63 (8.86 ±9.69) kg. ResultsThere were 5 in-hospital deaths (mortality at 3.50%). Three patients occurred abnormal bleeding (2.10%). Five patients (3.50%) performed the second B-T because of shunt occlusion. And the other patients recovered uneventfully. A total of 129 case times were followed up for 6-48 (14.38±10.05) months. Seven B-T case times (5.43%) were performed in 6 patients again because of shunt occlusion during the follow-up. Three patients died during the follow-up (mortality at 2.33%). A total of 88 patients of survival underwent corrective surgery or stage Ⅱ palliative surgery (68.22%). Main pulmonary artery have a significant increase in diameter during the follow-up(t=-15.18, P=0.00). Postoperative diameters of left pulmonary artery (t=-13.27, P=0.00), right pulmonary artery (t=-15.94, P=0.00), and right pulmonary artery (t=2.44, P=0.02) increased with statistical differences compared with preoperative values. Growth in ipsilateral pulmonary of B-T is better than that of the contralateral pulmonary (t=2.44, P=0.02). McGoon ratio increased significantly after B-T (t=10.10, P=0.00). Ejection fraction value was slightly lower than the preoperative value (t=2.77, P=0.00). Left ventricular mass index increased significantly compared with the preoperative value(t=-9.26, P=0.00). ConclusionsThe modified B-T shunt has been proved to be safe and effective in treating for complex congenital heart disease. It can significantly promote the development of pulmonary artery, especially the ipsilateral pulmonary of B-T. Small McGoon ratio and pulmonary atresia are the risk factors for limiting the further development of pulmonary. Appropriate diameter of B-T shunt choice according to preoperative pulmonary diameter and the weight of the patients is the basis to ensure successful operation and a good prognosis.