Early outcome of palliative shunt surgery for cyanotic congenital heart disease in Songklanagarind Hospital

Abstract

The Modified Blalock-Taussig (MBT) shunt provides excellent palliation for patients with cyanotic heart disease with diminution of pulmonary blood flow. This retrospective study reviewed our results as a developing cardiac center, comparing them with those in the literature. Between July 2001 and June 2003, forty-two patients (21 male and 21 female) underwent 44 MBT shunts in Songklanagarind Hospital. The age ranged from 3 days to 13 years (median=12 months, P25-75= 6-36) and four patients were neonates. Patients' weight ranged from 1.9 to 27 kg (median=8.2 kg, P25-75= 5.5-10.8). Tetralogy of Fallot comprised the majority of cases (59.5%). Varying sizes of grafts were used. Acute shunt failure occurred in 2 cases (one case with 3-mm and one case with 6-mm graft). Both received perioperative heparin, and reoperations for contralateral MBT shunts were performed with satisfactory results. The 30-day mortality was 2.4% (1/42) in this study. The increase in oxygen saturation after the procedures was significant (P < 0.001) and there was an increasing trend of early postoperative O2 saturation difference for patients with lower preoperative O2 saturation. In conclusion, the MBT shunt is an acceptable alternative palliative procedure for patients requiring a systemic-pulmonary shunt. This report showed an early morbidity and mortality rate which were comparable to that of other studies.

Keywords

• palliative shunt, cyanotic congenital heart disease