Blalock-Taussig (BT) Shunt

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A Blalock-Taussig (BT) shunt is a small tube that connects the arterial circulation to the pulmonary circulation in order to get more blood to the lungs. This is the first in a series of operations required to correct complex congenital (present at birth) heart defects. A BT shunt is a temporary fix, as it is only a certain size, but it allows the baby to grow to better prepare for his or her next operation.

BT shunts can be used to treat conditions such as pulmonary atresia, pulmonary stenosis, Tetralogy of Fallot, hypoplastic left heart syndrome and tricuspid atresia.

The cardiothoracic surgeons at Norton Children’s Heart Institute, affiliated with the UofL School of Medicine, have been placing BT shunts for decades. Children usually undergo this surgery in the first week of life.

Norton Children’s Heart Institute is the leading provider of pediatric heart care in Louisville and Southern Indiana.

Norton Children’s Heart Institute has a network of remote diagnostic and treatment services in Kentucky and Southern Indiana.

What Is a Blalock-Taussig (BT) Shunt?

A Blalock-Taussig (BT) shunt is a small tube, only a few millimeters wide, that is used to create a pathway for blood to go from the arterial circulation to the lungs. It is used to treat congenital heart defects that affect blood flow to the lungs. The shunt is used temporarily, when a child is very young, until a second operation can be performed. Because the shunt does not grow with the baby, it is not a long-term solution. A growing child will “outgrow” the shunt, eventually needing more blood flow to the lungs to meet the body’s oxygen needs.

Board-certified and fellowship-trained pediatric cardiothoracic surgeons at Norton Children’s Heart Institute will surgically install the BT shunt either on or off cardiopulmonary bypass (a heart-lung machine), depending on what kind of heart defect they are treating.

What Happens During a BT Shunt Procedure?

The Blalock-Taussig (BT) shunt mimics the role of the ductus arteriosus, meaning it allows blood to flow from a major artery through a connection to the pulmonary artery. Not only does this allow more blood to be oxygenated by the lungs, it also encourages the pulmonary arteries to grow, making the next surgery easier.

A BT shunt is tiny, measuring less than 5 millimeters (0.20 inches) in diameter. A surgeon attaches the two ends of the shunt to a major blood vessel, such as the subclavian artery, and to the pulmonary artery. The high-pressure arterial system will force blood through the BT shunt to the lungs to pick up more oxygen. The shunt helps to return healthy color to a child whose skin, lips or fingernails may have appeared blue (cyanosis) because of low oxygen levels in the blood. But even with a BT shunt, children likely will not have normal oxygen saturation levels and can appear blue, or cyanotic. The child’s oxygen saturation levels after a BT shunt will depend on the type of heart defect that is being repaired.

BT Shunt After Care

Blalock-Taussig (BT) shunt care after surgery will include:

  • Mechanical ventilation — a breathing machine — immediately following the operation
  • Chest tubes to collect fluid that can accumulate in the chest
  • Foley catheter to collect urine and accurately keep track of urine output

Many children with a BT shunt will need to be closely monitored at home. Our team at Norton Children’s Heart Institute will provide you with the monitoring equipment, train you in how to use it, and continually check in on your child until he or she is ready for the next operation.

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Why Choose Norton Children’s Heart Institute

  • Norton Children’s Hospital has been a pioneer in pediatric cardiothoracic surgery, performing Kentucky’s first pediatric heart transplant in 1986 and becoming the second site in the United States to perform an infant heart transplant.
  • The American Board of Thoracic Surgery has certified our cardiothoracic surgeons in congenital heart surgery.
  • The Adult Congenital Heart Association has accredited Norton Children’s Heart Adult Congenital Heart Disease Program as the only comprehensive care center in Kentucky and Indiana treating adults born with a heart defect.
  • More than 17,000 children a year visit Norton Children’s Heart Institute for advanced heart care.
  • Norton Children’s Heart Institute has offices across Kentucky and Southern Indiana to bring quality pediatric heart care closer to home.
  • The Jennifer Lawrence Cardiac Intensive Care Unit (CICU) at Norton Children’s Hospital is the largest dedicated CICU in Kentucky, equipped with 17 private rooms and the newest technology available for heart care.

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