Outcomes of Infants Undergoing Modified Blalock-Taussig Shunt Procedures in Oman: A retrospective study

Abstract

Objectives: A modified Blalock-Taussig (mBT) shunt procedure is a common palliative surgery used to treat infants and children with cyanotic congenital heart disease (CCHD). This study aimed to report the outcomes of infants and children undergoing mBT shunt procedures in Oman. In addition, risk factors associated with early mortality, inter-stage mortality and reintervention were assessed. Methods: This retrospective cohort study was conducted from January 2016 to December 2018 at the National Heart Centre, Muscat, Oman. All paediatric patients with CCHD undergoing mBT shunt procedures as a primary palliative procedure during this period were included. Data were retrieved from electronic hospital records. Kaplan-Meier survival curves were used to describe overall survival. Results: A total of 50 infants and children were included in the study. The in-hospital mortality and inter-stage mortality rates were 10% and 6.7%, respectively. Preoperative mechanical ventilation (odds ratio [OR]: 3.00, 95% confidence interval [CI]: 1.98–4.76; P = 0.007) and cardiopulmonary bypass (OR: 4.09, 95% CI: 2.44–6.85; P = 0.002) were significant risk factors for early mortality. In-hospital and interval surgical reintervention rates were 12% and 13.3%, respectively. Following the primary shunt procedure, the median time to second-stage surgery was 15.5 months (range: 5.0–34.0 months). Conclusion: The findings of this study support those reported in international research regarding the risks associated with mBT shunt surgeries. In particular, preoperative mechanical ventilation and cardiopulmonary bypass were significant risk factors for early mortality.

Keywords: Pediatrics; Heart Diseases, congenital; Cardiovascular Surgical Procedures; Modified Blalock-Taussig Procedure; Patient Outcome Assessment; Hospital Mortality; Risk Factors; Oman.