Open Access

ARTICLE

Blalock-Taussig shunt versus patent ductus arteriosus stent as first palliation for ductal-dependent pulmonary circulation lesions: A review of the literature

by

1 The Cardiac Center at the Children’s Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
2 The Lillie Frank Abercrombie Section of Cardiology, Texas Children’s Hospital, Baylor College of Medicine, Houston, Texas
3 The Heart Institute, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio
4 Sibley Heart Center Cardiology, Children’s Healthcare of Atlanta, Emory University School of Medicine, Altanta, Georgia
5 Center for Pediatric Clinical Effectiveness, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania

* Corresponding Author: Andrew C. Glatz, MD, MSCE, Children’s Hospital of Philadelphia, 6th Floor, Main Building, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104. Email:

Congenital Heart Disease 2019, 14(1), 105-109. https://doi.org/10.1111/chd.12707

Abstract

Background: Infants with ductal-dependent pulmonary blood flow (PBF) often undergo a palliative procedure to provide a stable source of PBF prior to definitive palliation or repair. In the current era, a surgical shunt or ductal stent is used to provide PBF. We aimed to review the current literature comparing ductal stents to surgical shunts.
Methods and Results: Four small, single-center studies and two larger multicenter studies were identified comparing ductal stent to surgical shunt. Combined, these studies showed ductal stent resulted in similar or improved pulmonary artery growth, fewer complications, shorter length of stay, less diuretic use, and improved survival compared to surgical shunt. Despite inherent minor variability among the studies, ductal stent appears to be associated with more frequent reinterventions.
Conclusions: Surgical shunts remain essential to the care of these patients, but ductal stent is a reasonable alternative, and may provide some advantages in select patients with ductal-dependent PBF.

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