This article is about one of the most common severe birth defects of the heart, a condition called Tetralogy of Fallot. To learn more about the condition itself, you can read my article on it. This feature is about "Palliative Operations" for those patients who arenīt candidates for a complete one-stage correction.
What are the palliative operations for ToF ?
First, by increasing the total lung blood flow, the amount of oxygen available for distribution to the rest of the body is increased. Second, the increasing amount of blood flowing into the pulmonary artery and its branches stimulates them to grow in size. The narrow portions may become wider. So, later, when an operation for total correction is performed, there is little or no obstruction to lung blood flow. What are the types of systemic - pulmonary shunts ?
The BLALOCK - TAUSSIG SHUNT.
How is this shunt created ?
How safe is a Blalock-Taussig shunt operation ?
A Blalock-Taussig shunt is a reasonably safe procedure. Complications are rare and include:
Blockage of the shunt. This causes the blue color to return. Clot dissolving medication, or even repeat operation may be required. Infection. Since the PTFE tube is a "foreign" material, it may become a site of implantation for bacteria that cause infection. Excessive lung blood flow. This happens rarely when an inappropriately large PTFE tube is used. If left uncorrected, this may cause thickening and hardening of the lung blood vessels which compromise later corrective surgery. Distortion of the pulmonary artery. As a child grows, the point at which the PTFE graft is attached to the artery may not grow, causing a bend or kink in the pulmonary artery at that point. What are the other types of "Shunt" operations ?
Instead of choosing the subclavian artery, other branches or even the aorta itself may be used in a shunt. In the POTTS shunt, a direct connection is made between the lower part of the aorta (on the left side of the chest) and the left branch of the pulmonary artery. This operation was popular earlier, but has more or less been given up now. This is because of certain drawbacks, both in its function, and in the difficulty of closing it during the time of the total correction operation. In the WATERSTON - COOLEY shunt, a connection is made between the back of the aorta and the right branch of the pulmonary artery. Though still popular in some hospitals, it is a difficult operation to perform perfectly. In the DAVIDSON shunt, a short tube of PTFE is used to create a shunt between the aorta and the pulmonary artery through an opening in the middle of the chest.
Dr. Mani Sivasubramanian, M.D., is a qualified heart surgeon and a self-confirmed web-aholic. He is a specialist in heart surgery for children.
For more information visit: http://www.dencats.org/heart/index.htm
Note: The information provided herein is of general nature, and should not be construed as professional medical advice.