PATENCY AND DEVELOPMENT OF STENOSIS IN MODIFIED BLALOCK-TAUSSIG SHUNTS CONSTRUCTED USING EXPANDED POLYTETRAFLUOROETHYLENE

Construction of a modified Blalock-Taussig shunt using polytetrafluroe thylene is frequently used for palliation in infants with complex cyan otic heart disease. This study was performed to assess angiographicall y the late patency rate of such prosthetic shunts. A modified Blalock- Taussig shunt had been constructed in 82 children and, of these, 63 (7 7%) patients had post-operative angiography and were included in this study. There were 29 males and 34 females, ranging in age from 1 day t o 164 months. A second shunt was needed in 7 patients. Thus, 70 shunts were studied. Of the shunts, 16 were 4 mm in diameter, 28 shunts 5 mm in diameter, and 26 shunts 6 mm in diameter. Postoperative angiograph y was performed on 1 day to 132 months (median 39 months) after constr uction of the shunts. Acute post-operative occlusion occurred in 2 (3% ) patients, who had 5 and 6 mm shunts, respectively. At the latest fol low-up (median 39 +/- 26 months), 6 (9%) late occlusions were noticed. Overall patency was 89% for all the shunts, with 94 % of the 4 mm shu nts, 85% of the 5 mm and 88% of the G mm shunts being patent. Regressi on analysis showed a progressive reduction in diameter of the graft wi th time. This narrowing of the graft may have been related to the form ation of a 'neointima' due to fibrous hyperplasia.