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

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

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