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KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
TERMINOLOGY
Abbreviations
Blalock-Taussig (BT) shunt
Definitions
Palliative procedure to augment pulmonary blood flow in various uni- & biventricular anatomies: Tetralogy of Fallot, tricuspid atresia, pulmonary atresia, & hypoplastic left heart syndrome (part of Norwood stage 1)
Original/classic BT shunt
Developed in 1945 by Dr. Alfred Blalock, Dr. Helen Taussig, & Vivien Theodore Thomas
Ligation & division of right subclavian artery with end-to-side anastomosis of proximal right subclavian artery to right pulmonary artery
Complications included shunt thrombosis, overshunting, nerve injury, & potential growth disturbance of ipsilateral upper extremity
Rarely performed today
Modified BT shunt
Synthetic graft prosthesis (Gore-Tex) between subclavian artery & ipsilateral pulmonary artery, contralateral to side of aortic arch
End-to-side anastomosis at each connection performed through median sternotomy or lateral thoracotomy (with former preferred)
Preserves blood flow to ipsilateral upper extremity
More easily placed on side contralateral to aortic arch
Up to 90% patency rate at 2 years of age
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Echocardiographic Findings
Angiographic Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
Selected References
Dirks V et al: Modified Blalock Taussig shunt: a not-so-simple palliative procedure. Eur J Cardiothorac Surg. 44(6):1096-102, 2013
McKenzie ED et al: The Blalock-Taussig shunt revisited: a contemporary experience. J Am Coll Surg. 216(4):699-704; discussion 704-6, 2013
Shauq A et al: Surgical approaches to the blalock shunt: does the approach matter? Heart Lung Circ. 19(8):460-4, 2010
Gaca AM et al: Repair of congenital heart disease: a primer-part 1. Radiology. 247(3):617-31, 2008
Williams JA et al: Two thousand Blalock-Taussig shunts: a six-decade experience. Ann Thorac Surg. 84(6):2070-5; discussion 2070-5, 2007
van Rijn RR et al: Development of a perigraft seroma around modified Blalock-Taussig shunts: imaging evaluation. AJR Am J Roentgenol. 178(3):629-33, 2002
Yoshimura N et al: Classic Blalock-Taussig shunt in neonates. J Cardiovasc Surg (Torino). 40(1):107-10, 1999
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
TERMINOLOGY
Abbreviations
Blalock-Taussig (BT) shunt
Definitions
Palliative procedure to augment pulmonary blood flow in various uni- & biventricular anatomies: Tetralogy of Fallot, tricuspid atresia, pulmonary atresia, & hypoplastic left heart syndrome (part of Norwood stage 1)
Original/classic BT shunt
Developed in 1945 by Dr. Alfred Blalock, Dr. Helen Taussig, & Vivien Theodore Thomas
Ligation & division of right subclavian artery with end-to-side anastomosis of proximal right subclavian artery to right pulmonary artery
Complications included shunt thrombosis, overshunting, nerve injury, & potential growth disturbance of ipsilateral upper extremity
Rarely performed today
Modified BT shunt
Synthetic graft prosthesis (Gore-Tex) between subclavian artery & ipsilateral pulmonary artery, contralateral to side of aortic arch
End-to-side anastomosis at each connection performed through median sternotomy or lateral thoracotomy (with former preferred)
Preserves blood flow to ipsilateral upper extremity
More easily placed on side contralateral to aortic arch
Up to 90% patency rate at 2 years of age
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Echocardiographic Findings
Angiographic Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
Selected References
Dirks V et al: Modified Blalock Taussig shunt: a not-so-simple palliative procedure. Eur J Cardiothorac Surg. 44(6):1096-102, 2013
McKenzie ED et al: The Blalock-Taussig shunt revisited: a contemporary experience. J Am Coll Surg. 216(4):699-704; discussion 704-6, 2013
Shauq A et al: Surgical approaches to the blalock shunt: does the approach matter? Heart Lung Circ. 19(8):460-4, 2010
Gaca AM et al: Repair of congenital heart disease: a primer-part 1. Radiology. 247(3):617-31, 2008
Williams JA et al: Two thousand Blalock-Taussig shunts: a six-decade experience. Ann Thorac Surg. 84(6):2070-5; discussion 2070-5, 2007
van Rijn RR et al: Development of a perigraft seroma around modified Blalock-Taussig shunts: imaging evaluation. AJR Am J Roentgenol. 178(3):629-33, 2002
Yoshimura N et al: Classic Blalock-Taussig shunt in neonates. J Cardiovasc Surg (Torino). 40(1):107-10, 1999
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