Blalock-Taussig shunt

Dr Mostafa El-Feky ◉ and Assoc Prof Frank Gaillard ◉ ◈ et al.

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 Blalock-Taussig shunt nowadays uses a synthetic graft, usually expanded polytetrafluoroethylene (Gore-Tex^®), to connect the arteries.

History and etymology

The Blalock-Taussig shunt was the first surgical systemic-artery-to-pulmonary-artery shunt ². The procedure was named after Alfred Blalock (surgeon to first perform this procedure) and Helen Taussig (pediatric 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 Blalock-Taussig 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.

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Congenital heart disease

There is more than one way to present the variety of congenital heart diseases. Whichever way they are categorized, 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.