MODIFIED BLALOCK-TAUSSIG SHUNTS - TO HEPARINIZE OR NOT TO HEPARINIZE

OBJECTIVE: To demonstrate shunt function of modified Blalock-Taussig S hunts (MBTSs) when no heparin is administered postoperatively. PATIENT S AND INTERVENTIONS: Twenty-four MBTSs were performed on 23 children w ith various congenital heart problems needing palliation before the pr imary repair could be completed A single low dose of heparin was given intraoperatively and no heparin was given postoperatively. Patients w ere evaluated for shunt patency, bleeding problems and the incidence o f significant seromas at the graft site. MAIN RESULTS: There was one p erioperative death and no incidence of early shunt failure. Two childr en died from causes unrelated to shunt function. There were no postope rative bleeding difficulties (no reoperations), and no seromas surroun ding the grafts. Late follow-up (mean 18+/-1 months) revealed no shunt failure. CONCLUSIONS: Avoidance of heparin after an MBTS procedure is a safe practice and may reduced bleeding problems and the incidence o f significant seromas surrounding the graft. Postoperative shunt throm bosis is more likely related to intraoperative technical difficulty or extremely small pulmonary artery size.