Abstract
Between January, 1985 and December, 1990, a total of 48 patients underwent Blalock-Taussig shunt operation. Of these patients, twenty-seven patients who had no preceding shunt and stenosis of anastomotic site were reviewed in terms of pulmonary artery growth in relation to the operation ages. The mean age at operation and duration of palliation were 9.9 (range 0.2 to 37) and 34.2 (range 12 to 70) months, respectively. Anomalies of these patients were: tetralogy of Fallot in 11, transposition of great arteries in 3, double outlet right ventricle in 3, tricuspid atresia in 3, common A-V canal with PS in 3, pulmonary atresia with intact ventricular septum in 4. As an index of pulmonary artery growth, pulmonary artery index (PAl) ratio (post-shunt PAI/pre-shunt PAl) was calculated. The PAI ratio significantly correlated with the operation age (r=0.57, p<0.0l), and the correlation changed at 2 or 12 month old. Accordingly, twenty-seven patients were divided into following two groups: patients aged over 12 months (group 12≦, n=11); those under 12 months (group 12≷, n=16), the latter group patients were divided into two subgroups: patients aged over 2 months (group 2≦, n=7); those under 2 months (group 2>, n=9). Group 12> showed a significantly increased PAI ratio compared to group 12≦ (12≦ : 121 ± 28, 12> : 219 ± 95%, p<0.005), and then, the PAI ratio increased significantly in group 2>compared to group 2≦(2≦ : 158 ± 22,2> : 264 ± 104, p<0.025). In summary, the greatest growth of pulmonary artery was observed in patients operated under 2 month old. Therefore, in order to expect a sufficient growth of pulmonary artery, Blalock-Taussig shunt should be performed in early infancy.
