Systemic-pulmonary artery anastomoses in infancy.

Over the last 10 years, 142 systemic-pulmonary artery anastomoses were performed in 134 infants under 1 year of age. These included shunts from the subclavian artery (46 per cent), ascending aorta (41 per cent), descending aorta (9 per cent), and superior vena cava (1 per cent) to the pulmonary artery. Ninety-six (72 per cent) of the infants were less than 4 months of age at the time of the initial procedure, and one half were less than 1 month old. When groups of patients were compared according to diagnosis and age at the time of operation, the immediate and long-term results of the subclavian-pulmonary artery (Blalock-Taussig) anastomosis were better than the results with the other procedures. In view of the ease of closure of this anastomosis at the time of corrective surgery, as well as the recent further improvement of vascular surgical techniques, the Blalock-Taussig shunt is the procedure of choice in most infants requiring a systemic-pulmonary artery anastomosis, even during the early months of life.