Stent Therapy for Clotted BlalockTaussig Shunts

摘要

Patients with large inter-ventricular communication and severe right ventricular outflow obstruction, including pulmonary atresia, require surgical intervention. Corrective surgery, when feasible, is the preferred treatment option. When total correction is not feasible, either because of the age and size of the patient at presentation or because of anatomic complexity, surgical palliation with a variety of aorto-pulmonary shunts (reviewed elsewhere1) is undertaken. Subclavian artery to ipsilateral pulmonary artery anastomosis, first described by Blalock and Taussig2 stood the test of time and became a standard mode of therapy. More recently, insertion of an interposition Gore-Tex graft (W.L. Gore & Associates, Inc., Flagstaff, AZ) between the subclavian artery and ipsilateral pulmonary artery, commonly referred to as modified Blalock-Taussig (mBT) shunt, described by deLeval et al,3 has become the procedure of choice. In patients with single ventricle physiology, palliation with first stage Norwood procedure is performed; in such patients, mBT shunt is commonly used to provide pulmonary blood flow.