RSS feedB T Shunt – Blalock-Taussig shunt
By maitri | 1 comment
1BT Shunt
By Dr. Maitri Chaudhuri
Sometimes a newborn baby gets too much bluish from heart defects. Usually oxygen level of blood is low as there is hardly any blood supply to lungs. Common conditions are Tetralogy of Fallot, Pulmonary Atresia, Tricuspid Atresia etc.
Then a temporary surgery called BT Shunt (Blalock- Taussig Shunt) is done quickly. It is a Goretex Tube/ PTFE Tube placed between the subclavian artery and lung artery. This tube carries unobstructed continuous flow to lungs and baby’s oxygen levels improve.
A Blalock-Taussig Shunt or “BT Shunt” is used to help increase blood flow to the lungs in babies born with defects that obstruct blood flow to the lungs. The surgery entails opening the chest either through a left or a right thoracotomy approach and placing a Gore-Tex tube form the innominate artery to the pulmonary artery. This is a palliative procedure, meaning that in most cases the final repair will be done at a later date.
Precautions after BT Shunt
- A medicine called Aspirin is given to prevent clot formation inside the shunt
- Aspirin dose is 3-5mg/kg. So, dose is as per the baby’s weight
- Don’t miss even a single dose of Aspirin without doctor’s advise
- Baby should not get dehydration( lack of water in body)
- If baby gets diarrhea, vomiting, excessive sweating replace the lost fluid by ORS or visit your pediatrician
- If baby gets sudden breathing problem or turns too blue, BT shunt is getting obstructed. Rush to the cardiologist
- Every 3 months visit your cardiologist and get an echo done.
- Remember BT Shunt is Temporary. It does not grow with your child.
- Within 6 months to one year, child will need total correction
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Re Blalock-Taussig shunt:
Since HBO is showing “Something the Lord has Made,” a movie that explains how the first baby open-heart surgery, creating an anastomosis between the pulmonary artery and subclavian vein to permit the oxygenation of otherwise un-oxygenated blood in a baby\’s heart, I’ve been wondering why Vivien Thomas, the first black surgical techinician in American history, was not accredited for creation of the first heart-lung machine. He essentially had to create such a device to stop the Saxon’s baby’s heart for 3 minutes to allow completion of the procedure, as shown and explained in the film. I’ve read that he used surgical supply houses to assist him in providing the equipment to create the device necessary for the Blalock-Taussig shunt. But, I guess, in terms of success, Dr. Thomas Gibbon, creator of the first successful heart-lung machine to be performed for open-heart surgery on adult as well as pediatric patients in his laboratories at Thomas Jefferson Medical College, would be the first creator of the first heart-lung machine, with the assistance of IBM, in Philadelphia, PA. I answered my own question, I guess, but Thomas’ device, created during WWII, almost the same time as Gibbon’s, really should be included in discussions for the baby heart shunt surgery, or at least compared, maybe. I was aware of Dr. Gibbon’s contribution to cardiothoracic surgery from my mother, a nurse trained at Jefferson shortly after Gibbon’s successful creation and accordingly was also trained by Gibbon in some respect during her tenure at Jefferson. Incidentally, my mother and I both worked in cardiothoracic in-patient departments (at different Philadelphia hospitals), and also underwent coronary artery bypass graft (CABG) surgery. I am grateful to everyone, including Vivien Thomas, Thomas Gibbon, and I guess also Thomas Jefferson Medical College, and of course the young cardiothoracic surgeon and team who made writing this note to you possible. Thank you!