TY - CHAP M1 - Book, Section TI - Palliative Operations for Congenital Heart Disease A1 - Karamlou, Tara A1 - Cohen, Gordon A. A2 - Yuh, David D. A2 - Vricella, Luca A. A2 - Yang, Stephen C. A2 - Doty, John R. PY - 2014 T2 - Johns Hopkins Textbook of Cardiothoracic Surgery AB - Alfred Blalock and Helen Taussig ushered in the surgical treatment of congenital heart disease with the introduction in clinical practice of a systemic artery-to-pulmonary artery (PA) shunt in 1944. In the current era of early complete correction of congenital heart disease, the Blalock–Taussig shunt still plays an important role in the surgical management of newborns and infants with inadequate pulmonary blood flow.1–3 The paradigm shift emphasizing early complete repair is based on contemporary data demonstrating the deleterious effects of palliative physiology, coupled with the realization that most infants can tolerate operative correction. However, some malformations still require a staged approach toward eventual correction, while others may necessitate a palliative procedure when anatomic or patient factors preclude complete repair. A staged repair is often favored when there are extenuating technical issues that stem from morphologic complexity or severe extracardiac pathology that would make one-stage correction prohibitive. The functionally single ventricle (Chapter 77) is an example of this strategy, by which a staged palliative approach eventually achieves the goal of separating the pulmonary and systemic circulations. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/04/16 UR - accesssurgery.mhmedical.com/content.aspx?aid=1104595239 ER -