Blalock-Taussig shunt, also known as Blalock-Thomas-Taussig shunt, is a palliative procedure designed to increase pulmonary arterial blood flow in patients with right ventricular outflow tract obstruction (e.g. tetralogy of Fallot) or during initial staged repair of hypoplastic left heart syndrome.
Originally the shunt sacrificed the subclavian artery (with a distal ligation) and the proximal portion is routed downwards to an end to side anastomosis with the ipsilateral branch of the pulmonary artery. The modified BT shunt nowadays uses a synthetic graft, usually expanded polytetrafluoroethylene (Gore-Tex®), to connect the arteries.
History and etymology
The BT shunt was the first surgical sytemic-artery-to-pulmonary-artery shunt.2 The procedure was named after Alfred Blalock (surgeon to first perform this procedure) and Helen Taussig (paediatric cardiologist, who designed the shunt). Vivien Thomas, who was Blalock's laboratory technician, developed the procedure in laboratory dogs and adapted instruments for the first human surgery from those used on the experimental animals. The procedure was first performed in a 15-month-old girl with tetralogy of Fallot in November 1944 at Johns Hopkins University Hospital in Baltimore, Maryland (USA).
A modified BT shunt technique using "plastic prostheses" was first described by Klinner in 1962.4 This approach using a synthetic Gore-Tex graft in place of ligation of the subclavian artery yielded a less disruptive and more easily reversible outcome.
- 1. Topol EJ, Califf RM. Textbook of cardiovascular medicine. Lippincott Williams & Wilkins. (2007) ISBN:0781770122. Read it at Google Books - Find it at Amazon
- 2. Blalock A, Taussig HB. Landmark article May 19, 1945: The surgical treatment of malformations of the heart in which there is pulmonary stenosis or pulmonary atresia. By Alfred Blalock and Helen B. Taussig. JAMA. 1984;251 (16): 2123-38. Pubmed citation
- 3. Brogan TV, Alfieris GM. Has the time come to rename the Blalock-Taussig shunt?. Pediatr Crit Care Med. 2003;4 (4): 450-3. doi:10.1097/01.PCC.0000090014.95775.3A - Pubmed citation
- 4. Klinner W, Pasini M, Schaudig A. [Anastomosis between systemic and pulmonary arteries with the aid of plastic prostheses in cyanotic heart diseases]. Thoraxchirurgie. 1962;10:68-75. (Article in German).
Congenital heart disease
There is more than one way to present the variety of congenital heart diseases. Whichever way they are categorised, it is helpful to have a working understanding of normal and fetal circulation, as well as an understanding of the segmental approach to imaging in congenital heart disease.
congenital heart disease
- normal relationship between chambers and valves
- atrioventricular valves
- outflow tract
- great vessels
- venous inflow
- anomalous valves
- abnormal relationship of chambers and valves
- atrioventricular abnormality
- great vessel connection abnormality
- conotruncal cardiac anomalies
- pentalogy of Cantrell
- Shone syndrome
- congenital heart disease - chest x-ray approach
surgical repairs (mnemonic)
- arterial switch procedure
- Blalock-Taussig shunt
- double switch procedure
- Fontan procedure
- Glenn procedure
- Mustard repair
- Norwood procedure
- Pott shunt
- pulmonary artery banding
- Rastelli procedure
- Sano shunt
- Senning repair
- total repair of tetralogy of Fallot (TOF)
- unifocalisation procedure
- Waterston shunt