Blalock-Thomas-Taussig (BTT) Shunt: Early and Follow-Up Management

The so-called Blalock-Taussig (BT) shunt was a pioneering surgical procedure designed initially to palliate children with tetralogy of Fallot (TOF) and was first performed at Johns Hopkins University in 1944. Although it represented the first effective treatment for TOF, it is still used in a modified form today to treat besides TOF patients a various group of children who present with patent ductus arteriosus (PDA)-dependent cardiac leasions, who are not amenable for placement of a PDA stent to secure pulmonary blood flow. In January 2020, the Blalock–Taussig–Thomas Pediatric and Congenital Heart Center opened at John Hopkins and with that the former BT shunt was accordingly renamed as Blalock-Thomas-Taussig (BTT) shunt. The modified BTT Shunt (MBTTS) was first introduced in 1962 and is now performed more widely than the classic one. It consists of a Gore-Tex (PTFE) graft (3.5–5.0 mm in diameter) interposed between the innominate or subclavian artery and the ipsilateral pulmonary artery (PA). This can be placed on the left or right PA but is routinely on the right side. It is usually a non-bypass procedure and is performed through a lateral thoracotomy or median sternotomy.