The Blalock-Taussig shunt. Low risk, effective palliation, and pulmonary artery growth.

The Blalock-Taussig shunt has been used at our institution in 64 infants with cyanotic congenital heart disease who required palliation. Thirty-one of these children were less than 2 months of age at the time of operation. There were no early shunt closures. There were two hospital deaths (3%). There was only one hospital death in the 31 patients less than 60 days old. According to a life-table analysis, 87% +/- 9% (+/- 95% confidence limits) of the shunts were functioning at 1 year and 78% +/- 12% at 2 years. Results are similar in the subgroup of children less than 60 days of age at the time of operation or in the subgroup of children weighing less than 3,999 gm at operation. In infants with small pulmonary arteries, pulmonary arterial growth was excellent (ipsilateral pulmonary artery/descending aorta ratio 0.70 leads to 0.95 in 550 days, p less than 0.001; contralateral ratio 0.73 leads to 0.99 in 550 days, p less than 0.001). The Blalock-Taussig shunt can be performed with low risk, provides excellent palliation, and is associated with excellent pulmonary artery growth.