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What is Modified Blalock-Taussig Shunt explain?
This is usually done by interpositioning a PTFE (Goretex) graft of 3.5 or 4 mm in a neonate. It is better done by a left lateral thoracotoiny. Left pulmonary artery is dissected and looped proximal to the origin of its branches. Left subclavian artery is also dissected and looped. After clamping and opening the subclavian arteiy, end to side anastomosis of the Goretex graft is done using 7-0 or 6-0 prolene. Then pulmonary artery is clamped and
Figure : Classic Blalock-Tanssig (BT) Shunt
opened superiorly. Anastomosis between graft and pulmonary artery is done with 7-0 prolene. On removing the clamp there should be continuous a thrill on the pulmonary artery.
Figure: Modified B-T shunt
Shunts through Median Sternotomy.
After median sternotomy pericardium is opened. Right innominate-subclavian junction is chosen for distal anastomosis of the interposition Goretex graft. Distally it is anastomosed to right pulmonary artery as it courses between and behind aorta and superior vena cava.
which is the last enzyme in the thrombotic system?
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