Blalock-Taussig (BT) shunt

A Blalock-Taussig (BT) shunt is a small tube that connects the arterial circulation to the pulmonary circulation in order to get blood flow, or more blood flow, 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 have been placing BT shunts for decades. Children usually undergo this surgery in the first week of life.


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


The Society of Thoracic Surgeons has ranked Norton Children’s Heart Institute’s pediatric heart care among the best in the region. With our network of remote diagnostic and treatment services in Kentucky and Southern Indiana, your child can stay close to home for quality care.


What is a 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 cause a problem getting 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 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 mm (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. Now 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. Your 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

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.

Why choose Norton Children’s Heart Institute

No other congenital heart surgery program in Kentucky, Ohio or Southern Indiana is ranked higher by the Society of Thoracic Surgeons than the Norton Children’s Pediatric Cardiothoracic Surgery Program.

  • 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.
  • Our board-certified and fellowship-trained pediatric cardiovascular surgeons are leaders in the field as clinicians and researchers.
  • More than 5,000 children a year visit Norton Children’s Heart Institute, affiliated with the University of Louisville, for advanced heart care.
  • Norton Children’s Heart Institute successfully performs more than 17,500 procedures a year.
  • The Society of Thoracic Surgeons ranked Norton Children’s Heart Institute among the best in the region after studying years of our patients’ outcomes and our ability to handle a range of pediatric heart conditions, including the most severe.
  • Norton Children’s Heart Institute has satellite outpatient centers in Bowling Green, Frankfort, Owensboro and Paducah; 28 tele-echocardiography locations in Kentucky and Southern Indiana; and six fetal echocardiography locations across Kentucky.
  • The American Board of Thoracic Surgery has certified the cardiothoracic surgeons at Norton Children’s Hospital with subspecialty certification in congenital heart surgery.
  • The Jennifer Lawrence Cardiac Intensive Care Unit is under construction to give our patients the most advanced cardiac intensive care unit available.
  • Our multidisciplinary approach to pediatric heart surgery brings together our specialists in cardiothoracic surgery, cardiology, anesthesiology, cardiac critical care and other areas to create a complete care plan tailored for your child.
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Norton Children’s Heart Institute

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