[Angioplasty of the stenotic Blalock-Taussig]

Abstract

Background: Balloon angioplasty is a useful therapeutic method in some congenital heart diseases. We show our experience of stenotic Blalock-Taussig angioplasty, which was effective in six cases.

Patients and methods: Six symptomatic patients with different congenital heart diseases, reduced pulmonary blood flow and a previous Blalock-Taussig shunt (it was classic in three patients and modified in another three) underwent the procedure. Conventional angioplasty was performed in four cases and coronary angioplasty technique, under monorail system, was applied in the other two.

Results: After angioplasty, we observed an increase in the minimum luminal diameter from 1 +/- 0.7 to 4 +/- 0.5 mm (p < 0.01), a reduction in the percentage of the stenosis from 77 +/- 15 to 13 +/- 13 (p < 0.01) and an increase in oxygen saturation from 63 +/- 10% to 82 +/- 5% (p < 0.05). The effectiveness of the technique in an extreme case of a thrombosed Blalock-Taussig, hours later the surgery, is reported. In the follow-up, we observed a symptomatic improvement, stable oxygenation levels, and a tendency in the hematocrit reduction.

Conclusion: We consider that angioplasty of Blalock-Taussig shunt is indicated in those symptomatic patients, in whom a complete surgical correction is contraindicated. We demonstrate the effectiveness of the procedure, the coronary angioplasty, under monorail system is very useful for the stenotic modified Blalock-Taussig. It can be an effective technique when there is a postoperative thrombosis of the fistula.