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Blalock Taussig Shunt

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Balram Airan – 1st expert on this subject based on the ideXlab platform

  • Is sternotomy superior to thoracotomy for modified BlalockTaussig Shunt?
    Interactive Cardiovascular and Thoracic Surgery, 2013
    Co-Authors: Sachin Talwar, Manikala Vinod Kumar, Subramanian Muthukkumaran, Balram Airan

    Abstract:

    A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was: is sternotomy approach superior to a thoracotomy approach for a modified BlalockTaussig Shunt procedure? More than 58 papers were found using the search as described below, of which 11 papers represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. Three of seven papers compared the sternotomy and thoracotomy approaches. The operative approach was a significant predictor of Shunt failure. The criterion used to define early Shunt failure was either the complete occlusion during hospitalization or the need to return to the operating room for a second Shunt. The studies that compared the thoracotomy and sternotomy approaches observed increased Shunt failure rates in the thoracotomy group. The sternotomy approach was associated with advantages like less pulmonary artery distortion, ease of technical performance, cosmetic advantage of a single sternotomy incision, ease of ligation of patent ductus, less phrenic nerve injury, less collateral formation in chest wall adhesions and less thoracotomy induced scoliosis. However, other papers studied either the sternotomy approach only or the thoracotomy approach and drew conclusions regarding risk factors for operative morbidity and mortality. We conclude that the sternotomy approach is beneficial to neonates and infants undergoing modified BlalockTaussig Shunt when compared with the conventional thoracotomy approach.

  • Homograft saphenous vein versus polytetrafluoroethylene graft for modified BlalockTaussig Shunt
    Indian Journal of Thoracic and Cardiovascular Surgery, 2008
    Co-Authors: Arvind Kumar Bishnoi, Sachin Talwar, Shiv Kumar Choudhary, Anita Saxena, Shyam S Kothari, Rajnish Juneja, Milind Hote, V Devagourou, Balram Airan

    Abstract:

    Back ground
    Modified BlalockTaussig Shunt is an important initial palliation in a selected subset of patients. This randomized controlled study was conducted to evaluate and compare PTFE and homograft saphenous vein as a conduit for this purpose.

  • Homograft saphenous vein versus polytetrafluoroethylene graft for modified BlalockTaussig Shunt
    Indian Journal of Thoracic and Cardiovascular Surgery, 2008
    Co-Authors: Arvind Kumar Bishnoi, Sachin Talwar, Shiv Kumar Choudhary, Anita Saxena, Rajnish Juneja, Milind Hote, V Devagourou, Shyam Sunder Kothari, Balram Airan

    Abstract:

    Back ground Modified BlalockTaussig Shunt is an important initial palliation in a selected subset of patients. This randomized controlled study was conducted to evaluate and compare PTFE and homograft saphenous vein as a conduit for this purpose. Patients and Methods Thirty patients were prospectively randomized to receive either a Polytetrafluoroethylene (PTFE) or an antibiotic preserved homograft saphenous vein as conduit. Early results were analysed and compared. Results Mean graft size was 3.93 mm±0.53 and 4.2 mm±0.53 in the PTFE and vein group respectively. There were 3 hospital deaths in the vein group and none in the PTFE group. There were 2 early and no late Shunt thromboses in PTFE group while 1 early and 2 late thrombosis occurred in vein group. These differences were statistically insignificant. The incidence of post-operative bleeding, peri-graft seroma and operative time was less in vein then PTFE group. Palliation on follow-up was comparable in both groups. Conclusion This study failed to demonstrate any benefit of homograft saphenous vein over PTFE graft in terms of thrombotic complications and mortality. There was however less bleeding and peri-graft seroma formation in the Saphenous vein (SVG) group. Further studies with greater number of patients and longer follow-up are required to demonstrate the superiority of either of these conduits.

Jay F Fricker – 2nd expert on this subject based on the ideXlab platform

  • transcatheter closure of modified Blalock Taussig Shunt with gianturco grifka vascular occlusion device
    Catheterization and Cardiovascular Interventions, 1999
    Co-Authors: Mark H Hoyer, Rafael A Leon, Jay F Fricker

    Abstract:

    A 15-year-old girl with previous repair of a complex cyanotic congenital heart defect had persistence of a modified left BlalockTaussig Shunt that could not be ligated at surgery. Six years later, antegrade delivery of a Gianturco-Grifka Vascular Occlusion Device resulted in complete closure of the Shunt. Cathet. Cardiovasc. Intervent. 48:365-367, 1999.

Arvind Kumar Bishnoi – 3rd expert on this subject based on the ideXlab platform

  • Homograft saphenous vein versus polytetrafluoroethylene graft for modified BlalockTaussig Shunt
    Indian Journal of Thoracic and Cardiovascular Surgery, 2008
    Co-Authors: Arvind Kumar Bishnoi, Sachin Talwar, Shiv Kumar Choudhary, Anita Saxena, Shyam S Kothari, Rajnish Juneja, Milind Hote, V Devagourou, Balram Airan

    Abstract:

    Back ground
    Modified BlalockTaussig Shunt is an important initial palliation in a selected subset of patients. This randomized controlled study was conducted to evaluate and compare PTFE and homograft saphenous vein as a conduit for this purpose.

  • Homograft saphenous vein versus polytetrafluoroethylene graft for modified BlalockTaussig Shunt
    Indian Journal of Thoracic and Cardiovascular Surgery, 2008
    Co-Authors: Arvind Kumar Bishnoi, Sachin Talwar, Shiv Kumar Choudhary, Anita Saxena, Rajnish Juneja, Milind Hote, V Devagourou, Shyam Sunder Kothari, Balram Airan

    Abstract:

    Back ground Modified BlalockTaussig Shunt is an important initial palliation in a selected subset of patients. This randomized controlled study was conducted to evaluate and compare PTFE and homograft saphenous vein as a conduit for this purpose. Patients and Methods Thirty patients were prospectively randomized to receive either a Polytetrafluoroethylene (PTFE) or an antibiotic preserved homograft saphenous vein as conduit. Early results were analysed and compared. Results Mean graft size was 3.93 mm±0.53 and 4.2 mm±0.53 in the PTFE and vein group respectively. There were 3 hospital deaths in the vein group and none in the PTFE group. There were 2 early and no late Shunt thromboses in PTFE group while 1 early and 2 late thrombosis occurred in vein group. These differences were statistically insignificant. The incidence of post-operative bleeding, peri-graft seroma and operative time was less in vein then PTFE group. Palliation on follow-up was comparable in both groups. Conclusion This study failed to demonstrate any benefit of homograft saphenous vein over PTFE graft in terms of thrombotic complications and mortality. There was however less bleeding and peri-graft seroma formation in the Saphenous vein (SVG) group. Further studies with greater number of patients and longer follow-up are required to demonstrate the superiority of either of these conduits.