ALERT!

This site is not optimized for Internet Explorer 8 (or older).

Please upgrade to a newer version of Internet Explorer or use an alternate browser such as Chrome or Firefox.

Neonatal Off-Pump Blalock-Taussig-Thomas Shunt for Double Outlet Right Ventricle With RVOTO

Tuesday, January 6, 2026

By

Ahmed Wahba

Wahba A, Essa Y, M. Said S. Neonatal Off-Pump Blalock-Taussig-Thomas Shunt for Double Outlet Right Ventricle With RVOTO. January 2026. doi:10.25373/ctsnet.31009672

A 2.7 kg neonate who was born at 35 weeks' gestation had a fetal diagnosis of double outlet right ventricle (DORV). He had repeated and prolonged cyanotic spells after birth, and attempts to open the ductus arteriosus with prostaglandins had failed. He required intubation and paralysis to prevent the repeated cyanotic spells. A decision was made to proceed with a palliative systemic-to-pulmonary artery shunt as an initial stage. 

Through median sternotomy, a 4 mm diameter cryopreserved saphenous vein homograft was used to create a modified Blalock-Taussig-Thomas shunt between the innominate artery and the right pulmonary artery in an off-pump fashion. The postoperative course was uneventful, and the baby was extubated three days later and continues to do well in preparation for full repair in the upcoming months. 

References

  1. Mazurak M. To save the Blue Babies: The 80th anniversary of the first Blalock-Thomas-Taussig shunt and the 70th anniversary of the first successful tetralogy of Fallot repair. Kardiol Pol. 2024;82(10):1038-1039. doi: 10.33963/v.phj.102235. Epub 2024 Oct 29
  2. Taussig H, Blalock A. The tetralogy of Fallot; diagnosis and indications for operation; the surgical treatment of the tetralogy of Fallot. Surgery. 1947 Jan;21(1):145

Disclaimer

The information and views presented on CTSNet.org represent the views of the authors and contributors of the material and not of CTSNet. Please review our full disclaimer page here.

Comments

Submitted by Ben Davies on
Nice demonstration, a couple of questions please: 1. Do you consciously avoid using saphenous vein segments with valves within? 2. How do manage the duct? 3. What if any anticoagulation do you use interstage? 4. Have you noticed any venous endothelial pathology (venous varix formation or on the contrary, luminal loss) at the time of stage 2? Have you done any histology, for example? Many thanks
Submitted by Sameh Said on
Dear Dr. Davies Thank you for your comment and regarding your questions: 1. I use the segment of the saphenous vein that lack any valves, and it is usually a short segment that is needed. 2. Regarding the PDA: - If the patient is not totally dependent on the shunt, I get rid of the duct - If dependent and the duct is small, I leave it but just discontinue the prostaglandins and let the duct close on its own but if the duct is large and the patient will be over circulating from both having the PDA and the shunt, then I put a small vessel loop and clip around it and decrease its size (but it can be lifesaving if needed) 3. Postoperatively by about 2-3 hours, we start Heparin then Aspirin once PO intake is resumed. We do check platelet reactivity prior to stopping Heparin and if there is any concerns, either increase Aspirin dose or add Plavix. 4. I have encountered one case with saphenous vein aneurysm in a patient with single ventricle that was fixed at the time of the Glenn, but it was interesting in this case as the patient also had an aneurysm in the right PA where I used a patch from the saphenous vein to patch the RPA at the time of the initial shunt. 5. Have not done histology yet on these veins. Hope I answered your questions. Thank you.

Add comment

Log in or register to post comments
Submit Content
Printer-friendlyPrinter-friendly

Rate article

Share

Twitter logo Facebook logo Google+ logo LinkedIn logo

Tags