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Wednesday, January 09, 2008

Blalock and Taussig shunt is done between subclavian artery to the homolateral branch of the pulmonary artery

027. Blalock and Taussig shunt is done between:

1. Aorta to Pulmonary artery

2. Aorta to Pulmonary vein

3. Subclavian artery to Pulmonary vein

4. Subclavian vein to artery

Answer

1. Aorta to Pulmonary artery

Reference:

Nelson 15th Edition Chapter 387.2

Nelson 16th Edition Page 1527

Quality

Confusa

Status

Repeat

QTDF

All books

Answer taken from

No idea J

Discussion

The modified Blalock-Taussig shunt is currently the most common aorto-pulmonary shunt procedure and consists of a Gore-Tex conduit anastomosed side to side from the subclavian artery to the homolateral branch of the pulmonary artery. Sometimes the conduit is brought directly from the ascending aorta to the main pulmonary artery and is called a central shunt. The Blalock-Taussig operation can be successfully performed in the newborn period using 4-5 mm diameter shunts and has been utilized successfully in premature infants. The original Blalock-Taussig shunt consisted of a direct anastomosis of the subclavian artery to a branch pulmonary artery.

Explanation

Self Explanatory. The operation was first successfully performed on November 29, 1944: anastomosis between arteria subclavia and arteria pulmonalis in a case of Fallot's tetralogy. In short it is an anastomosis between a branch of aorta and pulmonary artery. Hence we can opt for the first choice as the “best option” even though it is not the correct option

Comments

Other shunt procedures include a side-to-side anastomosis of the ascending aorta and right pulmonary artery (Waterson) and anastomosis of the descending aorta and left pulmonary artery (Potts).

Tips

These procedures are rarely done because of a higher frequency of complicating congestive heart failure and a higher risk for the development of pulmonary hypertension as well as greater technical difficulties in closing these shunts during subsequent corrective surgery.

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