Background: Serous fluid leakage is an unusual but often devastating complication following the placement of a modified Blalock-Taussig shunt using a polytetrafluoroethylene graft.
Method And Results: Between September 1994 and September 1999, out of 268 patients undergoing a modified Blalock-Taussig shunt using polytetrafluoroethylene grafts, 10 developed massive pleural effusion or seroma due to a leak from the surface of the shunt. The age of the patients ranged from 9 days to 7 years. There were 7 males and 3 females. Nine patients presented with respiratory distress between 2 and 12 weeks of shunt surgery and one presented with sudden cardiac arrest. The shunt was patent in all the patients. Initial management was conservative. i.e. by pharmacological means and tube thoracostomy. Reoperation was undertaken in 9 patients when conservative treatment failed. All patients survived except one who had a cardiac arrest before any intervention could be carried out.
Conclusions: Patients with serous effusion have significant morbidity and mortality and often require reoperation. The initial management remains conservative but, if unsuccessful, re-exploration can be undertaken as it proved to be uniformly successful in our experience.
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Article Synopsis
- The study examined the use of right ventricular outflow tract (RVOT) stenting versus the modified Blalock-Taussig shunt (mBTS) as treatments for children with stenotic RVOTs aged 1 to 18, revealing limited literature on their comparative effectiveness.* -
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- Overall, RVOT stenting showed comparable results to mBTS concerning MACE and oxygen saturation levels at discharge, suggesting it could be a viable option for palliation in this patient population.*
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