Unilateral pulmonary edema: Blalock-Taussig shunt in pulmonary atresia with ventricular septal defect

Case contributed by Charlie Chia-Tsong Hsu
Diagnosis certain

Patient Data

Age: 20
Gender: Male

Posteroanterior chest radiograph demonstrate marked cardiomegaly with plethoric right lung. The right pulmonary artery are marked dilated receiving arterial blood from the BT shunt.  The BT shunt (systemic-to-pulmonary artery shunt) presents a volume load to the heart and sequelae of congested cardiac failure is evident. 

Case Discussion

The patient had cyanotic congenital heart disease with underdeveloped subpulmonic infundibulum/pulmonary valve atresia and associated ventricular septal defect (VSD). The patient underwent modified Blalock-Taussig (BT) shunt procedure and VSD repair in infancy. The modified BT shunt procedure entails the use of  a synthetic graft, usually polytetrafluoroethylene, with anastamotic connection between the right subclacian artery and the right pulmonary artery.

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