GROWTH OF THE SUBCLAVIAN ARTERY AND THE ANASTOMOSIS IN BLALOCK-TAUSSIG SHUNT - ABSORBABLE VERSUS NONABSORBABLE SUTURE

Background. We evaluated the growth of Blalock-Taussig shunts placed w ith absorbable suture by cineangiographic findings and long-term resul ts and compared them with those in an earlier group of patients in who m we used nonabsorbable suture. Methods. Eighty-one patients had posto perative cineangiography 1 year or more after a Blalock-Taussig shunt procedure. From September 1985 to December 1994, 40 patients (group I) underwent a Blalock-Taussig shunt procedure with the use of absorbabl e polydioxanone suture, and from January 1980 to August 1989, 41 (grou p II) underwent the same operation with nonabsorbable polypropylene su ture. Cineangiograms were reviewed to assess shunt patency and growth of the subclavian arteries and the subclavian artery-pulmonary artery anastomoses. Results. At the Blalock-Taussig shunt operation, mean out er diameters of the subclavian artery and the anastomosis in group I w ere 3.8 +/- 0.1 mm and 4.1 +/- 0.1 mm, respectively and 3.9 +/- 0.1 mm and 4.0 +/- 0.1 mm in group II. The mean inner diameters of the subcl avian artery and the anastomosis measured in postoperative cineangiogr ams were 7.9 +/- 0.5 mm and 4.6 +/- 0.2 mm, respectively in group I an d 6.6 +/- 0.4 mm and 3.1 +/- 0.2 mm in group II. The diameters of both the subclavian artery (p < 0.05) and the anastomosis (p < 0.001) were significantly greater in group I than in group II. Five years after o peration, 71.1% +/- 7.4% of patients in group I and 54.8% +/- 8.0% in group II had good palliation. Conclusions. The use of absorbable polyd ioxanone suture has an advantage in terms of growth of the diameters o f the subclavian artery and the anastomosis in a Blalock-Taussig shunt and may improve the long-term results after this shunt operation in i nfancy. (C) 1998 by The Society of Thoracic Surgeons.