Question 1430
{"accessible":false,"alternatives":[{"id":7126,"text":"Ebstein-Fallot shunt"},{"id":7127,"text":"Fontan procedure"},{"id":7128,"text":"modified Blalock-Taussig shunt"},{"id":7129,"text":"Nuss procedure"},{"id":7130,"text":"Trendelenburg's operation"}],"archived":false,"correctAlternativeId":7128,"explanation":"\u003cp\u003eThe modified Blalock-Taussig shunt is the procedure described in the question, usually used as a temporising measure, pending definitive surgery. The shunt is generally right-sided if there is a left aortic arch, and left-sided if there is a right aortic arch. The purpose of this procedure is to direct more blood to the pulmonary circulation (and reduce the impact of the \u003ca title=\"Congenital pulmonary stenosis\" class=\"internal\" href=\"/articles/congenital-pulmonary-stenosis\"\u003epulmonary stenosis\u003c/a\u003e seen in tetralogy of Fallot) and therefore reduce the level of \u003ca title=\"cyanosis\" class=\"internal\" href=\"/articles/cyanosis\"\u003ecyanosis\u003c/a\u003e.\u003c/p\u003e\u003cp\u003eThe original Blalock-Taussig shunt involved an end-to-side anastomosis of the native subclavian (or innominate) artery to the ipsilateral pulmonary artery, resulting in the sacrifice of the subclavian on that side. This procedure has fallen out of favor, with the modified procedure have lower rates of mortality/morbidity.\u003c/p\u003e\u003cp\u003eThe Fontan procedure is used in patients with a single ventricle. There are a number of variations to this procedure but they generally involve diverting venous blood from the inferior vena cava and the superior vena cava to the pulmonary circulation and bypassing the morphological right ventricle. This is done by anastomosing the pulmonary trunk to the right atrium. Blood returning to the heart would, therefore, be flowing through the following structures (in sequence):\u003c/p\u003e\u003cul\u003e\n\u003cli\u003einferior vena cava and superior vena cava\u003c/li\u003e\n\u003cli\u003eright atrium\u003c/li\u003e\n\u003cli\u003epulmonary trunk and pulmonary circulation\u003c/li\u003e\n\u003cli\u003eleft atrium\u003c/li\u003e\n\u003cli\u003eleft ventricle\u003c/li\u003e\n\u003cli\u003eaorta\u003c/li\u003e\n\u003c/ul\u003e\u003cp\u003eA Nuss procedure is the insertion of a metal bar (or bars) behind the sternum to correct \u003ca title=\"Pectus excavatum\" class=\"internal\" href=\"/articles/pectus-excavatum\"\u003epectus excavatum\u003c/a\u003e.\u003c/p\u003e\u003cp\u003eA Trendelenburg\u0026nbsp;operation refers to two different procedures, one used in the surgical treatment of \u003ca title=\"Varicose veins\" class=\"internal\" href=\"/articles/varicose-veins\"\u003evaricose veins\u003c/a\u003e (ligation of the long saphenous vein at the groin)\u0026nbsp;and another being surgical embolectomy in pulmonary embolism.\u003c/p\u003e\u003cp\u003eThe Ebstein-Fallot shunt is not a real procedure!\u003c/p\u003e","id":1430,"imageUrl":null,"imageAttribution":null,"imageAttributionCaseInfo":null,"firstQuestionPath":"/questions/1430","nextQuestionPath":null,"relatedArticles":[{"id":7356,"title":"Tetralogy of Fallot","link":"/articles/tetralogy-of-fallot?lang=us"},{"id":34487,"title":"Fontan procedure","link":"/articles/fontan-procedure?lang=us"},{"id":13666,"title":"Nuss procedure","link":"/articles/nuss-procedure?lang=us"},{"id":43857,"title":"Total repair of tetralogy of Fallot","link":"/articles/total-repair-of-tetralogy-of-fallot?lang=us"}],"alsoUsedIn":[],"stem":"\u003cp\u003eA child born with tetralogy of Fallot undergoes a palliative procedure, pending full corrective surgery. They have an artificial graft inserted to create an anastomosis between the left subclavian artery and the ipsilateral pulmonary artery. What is the name of this procedure?\u003c/p\u003e","menuLinks":[{"text":"Report problem with question","url":"https://docs.google.com/forms/d/e/1FAIpQLSfO3soWYhOjJ7yErSysyCe5V4A1CqW7WK3rDA7MtAkecMGqNw/viewform?entry.1624461248\u0026entry.553583435=https://radiopaedia.org/questions/1430"}],"attemptsPercentages":[{"alternativeId":"7128","percentage":83},{"alternativeId":"7129","percentage":1},{"alternativeId":"7127","percentage":9},{"alternativeId":"7126","percentage":7},{"alternativeId":"7130","percentage":0}],"promptToLogin":false,"questionManager":false,"articleId":"blalock-taussig-shunt"}