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Eur J Cardiothorac Surg 2006;29:100-104
© 2006 Elsevier Science NL
a Department of Thoracic and Cardiovascular Surgery, Clinical Research Institute, Seoul National University Children's Hospital, College of Medicine, Seoul National University, 28 Yongon-Dong, Jongno-Gu, Seoul 110-744, Korea
b Department of Thoracic and Cardiovascular Surgery, Pediatrics, Sejong General Hospital, Sejong Heart Institute, Bucheon, Korea
Received 21 July 2005; received in revised form 17 October 2005; accepted 19 October 2005.
* Corresponding author. Tel.: +82 2 2072 3637; fax: +82 2 3672 3637. (Email: woonghan{at}snu.ac.kr).
Objective: The placement of a modified Blalock–Taussig shunt in patients suffering from pulmonary coarctation can result in the aggravation of uneven pulmonary blood flow. This may subsequently obviate the possibility of future performance of the Fontan procedure. The objective of this study was to evaluate mid-term results in patients with pulmonary coarctation who had undergone the placement of a modified Blalock–Taussig shunt, coupled with a pulmonary artery angioplasty. Methods: We retrospectively reviewed the records of 13 patients who had undergone the placement of a modified Blalock–Taussig shunt, coupled with concomitant pulmonary angioplasty, between September 1998 and August 2002. All patients received follow-up angiographic evaluations. Results: On the ipsilateral side of the modified Blalock–Taussig shunt, we observed a significant increase in the pulmonary artery index during a mean follow-up period of 11 ± 5 months (preoperative 82 ± 37 mm2/m2, follow-up 129 ± 57, p = 0.03). On the contralateral side, we also observed a significant increase in the pulmonary artery index (preoperative 90 ± 56 mm2/m2, follow-up 137 ± 56, p = 0.047). There was one late death. During the follow-up period (mean 23 ± 18 months), 10 patients received either a bidirectional or total cavopulmonary shunt and five of these patients underwent extracardiac Fontan operations. Conclusions: Our study demonstrated that the placement of a modified Blalock–Taussig shunt, with concomitant pulmonary artery angioplasty, constitutes a good initial surgical strategy in cases of univentricular heart with pulmonary coarctation.
Abbreviations: AV valve = atrioventricular valve • BCPA = bidirectional cavopulmonary anastomosis • D–K–S procedures = Damus–Kaye–Stansel procedures • MBTS = modified Blalock–Taussig shunt • PA = pulmonary artery • PAI = pulmonary artery index • PDA = patent ductus arteriosus • PTFE = polytetrafluoroethylene • Rp = pulmonary vascular resistance • TAPVD = total anomalous pulmonary venous drainage • TCPA = total cavopulmonary anastomosis • WU = Wood Unit
Key Words: Congenital heart disease • Univentricular heart • Fontan procedure • Pulmonary arteries • Angiography
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  T. Shinkawa, M. Yamagishi, K. Shuntoh, T. Miyazaki, T. Hisaoka, and H. Yaku Pulmonary Arterial Reconstruction for Pulmonary Coarctation in Early Infancy Ann. Thorac. Surg., January 1, 2007; 83(1): 188 - 192. [Abstract] [Full Text] [PDF]
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H. K. Kim and W.-H. Kim Reply to ugurlucan et Al. Eur. J. Cardiothorac. Surg., May 1, 2006; 29(5): 865 - 865. [Full Text] [PDF]
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