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The Blalock–Thomas–Taussig shunt (BTT shunt), [1] previously known as the Blalock–Taussig Shunt (BT shunt), [2] is a surgical procedure used to increase blood flow to the lungs in some forms of congenital heart disease [3] such as pulmonary atresia and tetralogy of Fallot, which are common causes of blue baby syndrome. [3]
The incidence of univentricular heart malformations is estimated at 0.1 to 0.4 per 1,000 live births. [3] In the neonatal period, these patients depend on an aortopulmonary shunt that is maintained medically with prostaglandin and then surgically with an initial cardiac shunt procedure.
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Arrhythmias: Abnormal heart rhythms can occur due to the congenital defect or secondary to manipulation of cardiac tissue during surgery. [31] Shunt Obstruction: The shunt (mBTTs or Sano) placed during the Norwood procedure that re-establishes pulmonary circulation can become narrowed or obstructed, necessitating urgent intervention. [27]
Technically it is very similar to the bidirectional Glenn procedure used to direct half the body's venous blood flow into the lungs. However, in patients with interrupted IVC, most of the blood from the lower body actually joins the blood from the upper body before returning to the heart via the superior vena cava (SVC).
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The fetal circulation is composed of the placenta, umbilical blood vessels encapsulated by the umbilical cord, heart and systemic blood vessels. A major difference between the fetal circulation and postnatal circulation is that the lungs are not used during the fetal stage resulting in the presence of shunts to move oxygenated blood and ...
The timing of surgery depends on the baby's symptoms and size. [8] The procedure involves increasing the size of the pulmonary valve and pulmonary arteries and repairing the ventricular septal defect. [8] In babies who are too small, a temporary surgery may be done with plans for a second surgery when the baby is bigger. [8]