What is Classic Blalock-Taussig BT Shunt in Shunt Operations ?
Subclavian artery, which arises from innominate artery, is anastomosed to pulmonary artery. In a patient with left aortic arch, the operation is done on the right side. Child is placed in left lateral position and a right lateral thoracotomy through third inter costal space is done. Right lung is retracted downwards and posteriorly and right pulmonary artery is dissected and looped. The anastomosis should be done on the right pulmonary artery as medially as possible. (Posterior to superior vena cava). Then dissection is carried superior to azygos vein to expose right subclavian artery. Vagus and recurrent laryngeal nerves ate identified. Dissection of the subclavian artery is carried out superiorly by ligating and dividing internal mammary and vertebral aterial branches. Subclavian artery is ligated at the point of exit from chest and divided after applying a vasculas clamp proximally. It is then taken medial to the vagus nerve and turned down to the right pulmonary artery. Clamp is applied on proximal right puhonary artery. The distal branches of pulmonary artery are looped and weighted down for haemostasis.
Right pulmonary artery is incised on its superior aspect and anatomises of the end of subclavian artery is made using double armed 7.0 prolene sutures. When the clamps are removed there should be a continuous thrill.