The Blalock-Taussig shunt for simple complete transposition of the great arteries followed by later anatomic correction. Report of 2 cases with conflicting postoperative courses.

The Blalock-Taussig (BT) shunt was performed in two infants with simple transposition of the great arteries (TGA) after poor response to septostomy not only to improve hypoxia but also in expectation of preparing the left ventricle for later anatomic correction. One patient had adequate muscle mass and pressure of the left ventricle after the shunt and underwent successful anatomic correction. The other patient developed intractable heart failure following the shunt. Anatomic correction was performed with success in this patient after pulmonary artery banding and takedown of the BT shunt. Based on these experiences, if heart failure does not develop or is controllable after BT shunt, there may be a possibility of later anatomic correction. However, if uncontrollable failure occurs, the shunt should be taken down and arterial or venous switch correction should be performed as soon as possible.