Optimal Surgical Management Using a Classic Blalock-Taussig Shunt for an Infected Pseudoaneurysm After a Modified Blalock-Taussig Shunt Procedure Noritaka.

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Optimal Surgical Management Using a Classic Blalock-Taussig Shunt for an Infected Pseudoaneurysm After a Modified Blalock-Taussig Shunt Procedure Noritaka Okada, MD, PhD, Hiroomi Murayama, MD, Hiroki Hasegawa, MD, PhD The Annals of Thoracic Surgery Volume 101, Issue 5, Pages 1992-1995 (May 2016) DOI: 10.1016/j.athoracsur.2015.07.057 Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Angiographic image of left-sided modified Blalock-Taussig shunt (mBTS) in case 1 demonstrates pseudoaneurysm formation arising from proximal anastomosis site. Pseudoaneurysm compressed shunt, resulting in extremely diminished blood flow. The Annals of Thoracic Surgery 2016 101, 1992-1995DOI: (10.1016/j.athoracsur.2015.07.057) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 (A and B) Computed tomography showing growing pseudoaneurysm and right-sided classic Blalock-Taussig shunt (BTS) before removal of infected graft in case 1. The Annals of Thoracic Surgery 2016 101, 1992-1995DOI: (10.1016/j.athoracsur.2015.07.057) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Angiographic image of left-sided modified Blalock-Taussig shunt (mBTS) in case 2 reveals pseudoaneurysm from proximal graft anastomosis, resulting in nearly occluded shunt flow. The Annals of Thoracic Surgery 2016 101, 1992-1995DOI: (10.1016/j.athoracsur.2015.07.057) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 (A and B) Computed tomography shows rapid dilatation of the pseudoaneurysm, thought to indicate an impending rupture just before removal of infected graft in case 2. The Annals of Thoracic Surgery 2016 101, 1992-1995DOI: (10.1016/j.athoracsur.2015.07.057) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions