Intrapericardial left modified Blalock-Taussig shunt : A rare case

Öz

The modified Blalock-Taussig shunt is the most commonly performed systemic to pulmonary artery shunt in children with cyanotic heart disease. Nowadays the approach has shifted from palliative procedures to earlier total correction. But modified Blalock-Taussig shunt is still a lifesaving procedure in cases with severe hypoplastic pulmonary arteries and concomittant coronary artery anomalies which disallow total correction. Here, we present a case with tetralogy of Fallot, mirror image aorta, right aortic arch and coronary artery anomaly. An intrapericardial left subclavian to left pulmonary artery shunt, which is a very rare entity, was performed with sternotomy.

Anahtar Kelimeler

• Blalock-Taussig shunt, tetralogy of Fallot, coronary anatomy

İntraperikardiyal sol modifiye Blalock-Taussig şant: nadir bir olgu

Öz

Modifiye Blalock-Taussig şant siyanotik kalp hastalıklarında en sık kullanılan sistemik pulmoner arter şantıdır. Günümüzde yaklaşım palyatif prosedürlerden, erken tüm düzeltmeye kaymıştır. Ancak modifiye Blalock-Taussig şant halen tüm düzeltmeye engel olan koroner arter anomalili ciddi hipoplastik arterli olgularda hayat kurtarıcı bir prosedürdür. Biz, burada Fallot tetralojili, sağ arkus aorta, ayna görüntüsü aortalı ve koroner arter anomalili bir hastayı sunuyoruz. Bu hastaya sternotomi ile nadir bir yaklaşım olan intraperikardiyal sol subklavyen-pulmoner arter şantı yapılmıştır.

Anahtar Kelimeler

• Blalock-Taussig şant, Fallot tetralojisi, koroner anomali

Kaynakça

1. Jahangiri M, Lincoln C, Shinebourne E et al. Does the Modified Blalock-Taussig Shunt Cause Growth of the Contralateal Pulmonary Artery? Ann Thorac Surg 1999;67:1397-9.
2. Takeda M, Furuse A, Takamoto F et al. Systemic-to- Pulmonary Shunt in a Patient With Isolation of the Subclavian Artery. Ann Thorac Surg 2000;69:940-2.
3. Williams J, Bansal A, Kim B et al. Two Thousand Blalock-Taussig Shunts: A Six-Decade Experience. Ann Thorac Surg 2007;84:2070-5.
4. Çetin G, Özkara A, Söyler İ et al. A novel tecnique for creation of a systemic-to-pulmonary arterial shunt. Cardiol Young 2005;15:31-4.
5. Li J, Soukias N, Carvalho S et al. Coronary artery anatomy in tetralogy of Fallot: Morphological and clinical correlations. Heart 1998;80:174-83.
6. Li FD, Fan QX, Zou CW et al. The effects of coronary abnormalities on recontruction of right ventricular outflow tract in patients with complex congenital heart disease. Zhonghua Wai Ke Za Zhi. 2006;15:655-7.
7. Brizard CP, Mas C, Sohn YS et al. Transatrial- transpulmonary tetralogy of Fallot repair is effective in the presence of anomalous coronary arteries. J Thorac Cardiovasc Surg. 1998;116:770-9.
8. Fernando A, Edmar A, Claudio R et al. Long term results of correction of tetralogy of Fallot in adulthood. Eur J Cardiothorac Surg 2004;25:250-5.

9. Odim J, Portzky M, Zurakowski D et al. Sternotomy approach for the modified Blalock-Taussig shunt. Circulation 1995;92:256-61. 10.
10. al. Systemic pulmonary shunts in neonates: Early clinical outcome and choice of surgical approach. Ann Thorac Surg 2000; 69:1499-504.