RT Book, Section
A1 Karamlou, Tara
A1 Cohen, Gordon A.
A2 Yuh, David D.
A2 Vricella, Luca A.
A2 Yang, Stephen C.
A2 Doty, John R.
SR Print(0)
ID 1104595239
T1 Palliative Operations for Congenital Heart Disease
T2 Johns Hopkins Textbook of Cardiothoracic Surgery
YR 2014
FD 2014
PB McGraw-Hill Education
PP New York, NY
SN 978-0-07-166350-2
LK accesssurgery.mhmedical.com/content.aspx?aid=1104595239
RD 2024/04/17
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.