2022, Vol. 26 ›› Issue (21): 3394-3400

Effect and histocompatibility of expended polytetrafluoroethylene in modified Blalock-Taussig shunt

Zhou Shicheng1, Han Hongguang2, Ji Fang3, Xu Liying2, Zhang Xiaohui2, Sun Chang2   

Abstract: BACKGROUND: Modified Blalock-Taussig shunt surgery is commonly used in severe cyanotic congenital heart disease. This surgery requires the establishment of new internal and external blood circulation pathways based on the anatomy and the development of the heart and lungs. At this time, a suitable blood vessel replacement is indispensable.
OBJECTIVE: To evaluate the effect and histocompatibility of expended polytetrafluoroethylene in modified Blalock-Taussig shunt.
METHODS: Totally 62 patients who were diagnosed with congenital heart disease and underwent a modified Blalock-Taussig shunt with expended polytetrafluoroethylene vessels at the age of 3 months-15 years were admitted from June 2009 to December 2019 in the General Hospital of Northern Theater Command. According to whether death occurred during hospitalization and follow-up, 57 cases were in the survival group and 5 cases were in the death group. The occurrence of complications was compared between the two groups. Binary logistic regression was used to analyze the risk factors of death. For the survivors, follow-up was performed to observe the histocompatibility of the expended polytetrafluoroethylene artificial vessel.
RESULTS AND CONCLUSION: (1) Postoperative SaO2 in patients increased immediately to above 80% with cyanosis alleviated significantly. Severe hypotension and arrhythmias occurred during the surgery in 8 patients (12.9%), 5 of which died in the perioperative phase in the death group. All the remaining 57 patients were followed up for one year. There were significant differences in the early postoperative bedside dialysis, hemoglobinuria, and perfusion lung between the two groups (P < 0.05). (2) Binary logistic regression analysis showed that low weight and severe low cardiac output during the surgery were risk factors for postoperative death after modified Blalock-Taussig shunt (P < 0.05). (3) During follow-up, the modified Blalock-Taussig shunt improved the development of the left ventricle and pulmonary artery. There was no occurrence of biological and anatomical adverse consequences like artificial conduit rupture or avulsion, hemolysis, rejection, nonstructural dysfunction, or structural injury. (4) The results show that Blalock-Taussing shunt for complex congenital heart disease can significantly relieve symptoms and promote the development of the left ventricle and pulmonary artery. The expended polytetrafluoroethylene has good short-term histocompatibility.
Key words: congenital heart disease, modified Blalock-Taussing shunt, biomaterials, expended polytetrafluoroethylene, artificial blood vessels, histocompatibility, palliative surgery, risk factors