Document Detail

Late-onset Blalock-Taussig shunt occlusion due to a subclavian artery pseudoaneurysm.
MedLine Citation:
PMID:  14564983     Owner:  NLM     Status:  MEDLINE    
A 3-month-old infant with tetralogy of Fallot presented with progressive severe cyanosis and intractable acidosis about 2 months after a successful modified right-sided Blalock-Taussig shunt. At cardiac catheterization, the suspected shunt malfunction was confirmed. It was due to a bulky, pear-like mass arising from the right subclavian artery and compressing the polytetrafluoroethylene conduit. Any attempt to recanalize the shunt by percutaneous techniques proved unsuccessful. At surgery, a huge dilation of the anterior wall of the right subclavian artery, that sharply bent the prosthetic conduit, was found. Pathologic examination revealed that the compressing mass was pseudo-aneurysmal in nature. Despite a second successful shunt operation with a dramatic clinical improvement, the patient died due to multiorgan failure 72 hours following surgery. Extrinsic compression by a false aneurysm is a rare cause of shunt occlusion that should always be suspected in patients presenting with a rapidly progressive shunt malfunction late after a successful shunt procedure.
Giuseppe Santoro; Gaetano Palma; Ettore Merlino; Maurizio Cappelli Bigazzi; Maria Teresa Palladino; Raffaele Calabrò; Carlo Vosa
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Italian heart journal : official journal of the Italian Federation of Cardiology     Volume:  4     ISSN:  1129-471X     ISO Abbreviation:  Ital Heart J     Publication Date:  2003 Aug 
Date Detail:
Created Date:  2003-10-20     Completed Date:  2004-03-09     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  100909716     Medline TA:  Ital Heart J     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  559-61     Citation Subset:  IM    
Department of Pediatric Cardiology, Second University of Naples, Naples, Italy.
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MeSH Terms
Acidosis / etiology*
Aneurysm, False / etiology*,  radiography
Cardiac Surgical Procedures / adverse effects*
Cyanosis / etiology*
Fatal Outcome
Subclavian Artery / radiography*
Tetralogy of Fallot / surgery*

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