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Article Type

Original Study

Abstract

Introduction The Blalock–Taussig shunt (BTS) is regarded as a safe and effective means of increasing pulmonary blood flow for cyanotic heart conditions. The evaluation of shunt size for postoperative hemodynamics and until second stage remains difficult. Our objective was to determine the outcome of an undersized M-BTS according to weight on immediate and after 12 months of follow-up in patients who had Tetralogy of Fallot with pulmonary atresia as a first step for total correction of biventricular repair. Patients and methods A total of 28 patients were recruited from January 2013 to December 2016. Clinical variables, such as age, sex, and weight, and perioperative variables, such as the diameter of the graft and branch pulmonary artery size, were reviewed. The mortality, morbidity, and O2saturation have been chosen as the outcome variables in immediate and 12-month follow-up results. Results A total of 28 M-BTSs were done with no mortality. All patients were done with right lateral thoracotomy. The mean age was 34 ± 31.9 months and weight was 12.2 ± 8.7 kg. There were 10 male and 18 female cases. The mean size of the shunt is 4.1 ± 0.9 mm. We used 5-mm shunts in eight cases, 4-mm shunts in 10 cases, 3.5-mm shunt in six cases, and 3-mm shunts in four cases. The mean size of the main pulmonary artery was 5.6 ± 1.5 mm, left pulmonary artery was 4.5 ± 1.6 mm, and right pulmonary artery was 6.5 ± 5.6 mm. Two patients had postoperative bleeding. Conclusion Undersized M-BTSs according weight reflect better immediate and short-term results in patients with Tetralogy of Fallot with pulmonary atresia.

Keywords

Modified Blalock–Taussig shunt, pulmonary atresia, Tetralogy of Fallot, undersized

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