Canadian journal of surgery. Journal canadien de chirurgie
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Over a 2-year period the authors inserted 22 systemic to pulmonary artery shunts using a polytetrafluoroethylene (PTFE) graft in 19 children. A modified Blalock-Taussig shunt was established in 18 instances and an aorta to pulmonary artery shunt in 3: one patient had an aorta to right ventricle infundibulum shunt. Three children had obstructed grafts and in two others the grafts became stenosed; on of the latter group had successful removal of thrombus. ⋯ The third child had a right ventricle to pulmonary artery shunt established for tetralogy of Fallot with pulmonary atresia; this resulted in some growth of the pulmonary arteries. The modified Blalock-Taussig shunt, using a PTFE graft, can be inserted without opening the pericardium, normal flow through the subclavian artery is not interrupted, the PTFE is easy to handle and the shunt can be inserted and taken down more easily than traditional shunts. For these reasons, the authors believe that this procedure, using PTFE, has an important role to play in the surgical management of children with congenital heart disease.