Division of modified Blalock-Taussig shunt at correction avoids distortionof the pulmonary artery

Background. Modified Blalock-Taussig (BT) shunt causing pulmonary artery di stortion has been reported. This distortion may get worse after a correctiv e operation if the BT shunt is ligated, rather than divided. In this study we examined whether division of modified BT shunt at the time of corrective operation would allow pulmonary artery growth and avoid further distortion . Methods. Fifteen patients who had modified BT shunts and subsequently had c orrective operations performed by one surgeon between January 1980 to Decem ber 1990 were analyzed. The median time from the BT shunt to corrective ope ration was 46.3 months (range, 3 to 119 months). At the time of corrective procedure, the BT shunt was divided and metal clips were used to occlude an d mark each end. At follow-up a chest roentgenogram was obtained and the di stance between the two clips was measured. Results. In all 15 patients measured sequentially the distances between the two clips increased steadily. Conclusions. Division of BT shunt at the time of corrective procedure reduc es pulmonary artery distortion. (C) 2001 by The Society of Thoracic Surgeon s.