Revista Brasileira de Cirurgia Cardiovascular
On-line version ISSN 1678-9741
ABRAHAO, Rogério et al. Esternotomia mediana como via preferencial na anastomose de Blalock-Taussig modificada. Rev Bras Cir Cardiovasc [online]. 1997, vol.12, n.2, pp. 166-168. ISSN 1678-9741. http://dx.doi.org/10.1590/S0102-76381997000200010.
The usual approach for systemic-pulmonary shunts has been right or left thoracotomy and interposition of a PTFE vascular graft between the subclavian and pulmonary arteries. This approach, necessarily causes, trauma to the lungs and some difficulty for dissection and ligation later during definitive surgical correction. Median sternotomy has been used occasionally for right subclavian-pulmonary artery anastomosis with certain advantages over thoracotomy. In this series, 10 patients were submitted to systemic-pulmonary modified Blalock-Taussig shunts by median sternotomy as the first choice. There have been no technical difficulties. The grafts were anastomosed to the right subclavian artery or brachiocephalic trunk. The right pulmonary artery was preferred, but when infeasible, this side of the shunt was made to the pulmonary trunk or left pulmonary artery. There have been 3 early and 1 late death, unrelated to the shunt. Arterial saturation improved by 27.5 ± 11.7% (p<0.001) post-operatively. This technique is viable, with advantages over lateral approach due to easier access, avoiding lung trauma, permitting surgical alternatives and canulation if needed and may facilitate dissection for later ligation.
Keywords : Anastomose cirúrgica [métodos]; Cirurgia cardíaca [métodos]; Atresia pulmonar [cirurgia]; Atresia tricúspide [cirurgia]; Dupla via de saída do ventrículo direito [cirurgia]; Estenose da valva pulmonar [cirurgia]; Anastomosis [surgical, methods]; Pulmonary atresia [surgery]; Tricuspid atresia [surgery]; Double outlet right ventricle [surgery]; Heart surgery [methods].