The BT shunt stands for the Blalock-Thomas-Taussig shunt, often referred solely as the Blalock-Taussig shunt. It is named after those who helped create it — Alfred Blalock (surgeon), Helen B. Taussig (cardiologist) and Vivien Thomas (lab technician).
Taussig came to the realization after working with many CHD patients that those who also had a Patent Ductus Arteriosus (PDA) lived longer. A PDA is a hole in the heart, specifically the aorta. This correlation, heart defect plus hole in the heart equalling a longer life, inspired the idea of a shunt. The shunt would act like a PDA to get blood oxygenated. Taussig brought the idea to Blalock and Thomas who accepted the challenge. Through many trials to perfect it, the BT shunt was created. After hundreds of animal trials were conducted by Blalock and Thomas, the BT shunt was ready for human use.
The first procedure of the BT shunt was conducted on November 29th, 1944 at Johns Hopkins Hospital on a less than 2 year old girl named Eileen Saxon. Following the surgery Eileen’s blueish coloring was lost and it was clear she was getting more oxygenated blood. Though the surgery was not a total success, as she required another surgery a few months later that took her life, it lasted long enough to show the positive impact of the procedure. Surgeons and doctors came from all over the world to learn the procedure from Blalock and Thomas and how to diagnosis the conditions that required the shunt from Taussig. Though modern technology and materials have changed, the main themes of the original procedure, pioneered by Blalock, Taussig and Thomas, remain the same.
The BT shunt, sometimes performed as a part of the Norwood procedure, connects the right subclavian artery, the first artery branching from the aorta, with the right pulmonary artery. Some of the blood that would normally go through the aorta to the body is funneled into the pulmonary artery and then to the lungs, via the shunt. Basically, it makes a route for blood to reach the lungs. This allows the blood to get oxygen. However the shunt is only a temporary fix, usually used for four to five months. Those months allow for the infant to grow before a bigger open-heart surgery is performed that will keep them stable for longer.
Pediatric Cardiologist, Dr. George Nicholson, gave some perspective on the procedure that is commonly done in his field. “The BT shunt has played a pivotal role in the advancement of pediatric cardiology and congenital cardiac surgery. However, there is room for improvement…” said Dr. Nicholson. He expressed that BT shunt patients are often extremely sensitive to change, infection and their environment — “making them arguably our most vulnerable patients.”
Speaking to the future, he hopes to see advancements in the materials that are used in the shunt as well as a version that has the capability of controlled growth. Overall he sees the impact of the BT shunt and the advancements that have come over the years, but sees opportunities for a better procedure. “There is a growing experience with [PDA] stent placement in lieu of BT shunt placement in certain infants…PDA stent patients…encounter a lower risk of procedural complications and shorter intensive care unit length of stay.”” Basically, the PDA stent is having the same survival rates as the BT shunt but with less complications.
The BT shunt has created life and hope for so many but still has its drawbacks. There is ample room for improvement. Where will this improvement come from? Research. Project Heart has been funding a research project with Dr. Tom Doyle, Dr. George Nicholson and Dr. Dana Janssen to create a novel PDA stent to replace the BT shunt procedure for some patients. We aim to continue the advancement of CHD research — and we’re just getting started.