Abstract
To determine if the Blalock-Taussig-Thomas shunt (BTTS) causes sufficient growth of hypoplastic branch pulmonary arteries (BPAs) to facilitate total correction or definitive palliation of cardiac lesions, PUBMED (PM) and Google Scholar (GS) were systematically searched between January 1st, 1966, and March 31st, 2023. Search terms included: Blalock, Taussig, shunt, pulmonary artery and Tetralogy of Fallot. Only full-text papers that measured pre-BTTS and post-BTTS BPA sizes using the Nakata Index or z-scores were included. Twenty full-text articles (718 patients) were included in this review. When the pre-BTTS right pulmonary artery (RPA) z-score that corresponds to the mean pre-BTTS NI was considered for each article, nineteen out of 20 articles (717 patients) had normal-sized RPAs (that is, their z-scores fell within the normal distribution). Although BPAs were found to grow post BTTS, available evidence suggests that most of the growth (67%) was due to BPA distension. A longer duration of BTTS did not increase BPA growth. The evidence available suggests that the modified BTTS does not produce sufficient ‘catch-up’ growth of hypoplastic BPAs to facilitate total correction or definitive palliation via the Fontan pathway.
Key words: Blalock-Taussig-Thomas shunt, pulmonary artery, growth.
