Modified Blalock-Taussig shunt using allograft saphenous vein: six years' experience.
BACKGROUND: The occurrence of life-threatening late infectious complications after the use of expanded polytetrafluoroethylene conduits as modified Blalock-Taussig shunts prompted us to apply allograft saphenous veins instead. METHODS: In 23 cyanotic patients (age, 1 week to 18 years) allograft saphenous veins were used for performing Blalock-Taussig shunts from July 1989 onward. Veins stored in Hank's solution were implanted in 8 patients and cryopreserved ones in 15. All patients were followed up regularly up to 15 months. RESULTS: There were two early and two late deaths: none were related to shunt occlusion. Clinical, angiographic, and echocardiographic studies proved that, except for one early occlusion, all shunts were patent and functioning well after an average of 41 months. Donor cells disappeared 1 to 3 days after implantation, and several months after the operation both the wall and the luminal surface of the grafts were repopulated with cells possibly of recipient origin. No difference was found between veins stored in Hank's solution only and cryo-preserved grafts, concerning clinical outcome and histology. CONCLUSIONS: Allograft saphenous veins function well as modified Blalock-Taussig shunts at least up to 6 years. Owing to the good results and lack of complications their clinical use is recommended.