Use of the Internal Thoracic Artery as a Suitable Conduit for Systemic-Pulmonary Shunt; a case report

Document Type : Case report



Introduction: There are a number of systemic-to-pulmonary artery shunts being performed by various surgeons. Currently the most widely used systemic-pulmonary shunt is the modified Blalock-Tausig shunt. This shunt is highly effective even in neonates with small pulmonary arteries. The case of a 15-year-old girl in whom the internal thoracic artery was used to create a systemic-pulmonary artery shunt after the failure of a previous Blalock-Tausig shunt is reported. This was the first report of such a case in which the internal mammary artery was used to establish systemic to pulmonary arterial flow in Iran.


1- Cobanoglu A, Abbruzzese P, Brauner D, Ferre B, Issenberg H, Starr A. Therapeutic considerations in congenital
absence of the right pulmonary artery. Use of internal mammary artery as a preparatory shunt. J Cardiovasc Surg
(Torino) 1984 May-Jun; 25(3):241-5.
2- Moodie DS, Ritter DG, Tajik AH, McGoon DC, Danielson GK, O’Fallon WM. Longterm follow-upafter palliative
operation for univentricular heart. AM J Cardiol 1984; 53:1648.
3- Sievers HH, Lange PE, Heintzen PH, Bernhard A. Internal mammary artery as a palliative systemic-pulmonary shunt
in order to develop diminutive pulmonary arteries. Thorac Cardiovasc Surg 1985 Feb; 33(1):51-2.
4- Barner HB, Barnett M: Fifteen to 21 years angiographic assessmentof internal thoracic artery as a bypass conduit.
Ann Thorac Surg 1994; 57:1526.
5- Toyoda Y, Yamaguchi M, Ohashi H, Imai M, oshima Y, Yoshimura N, Yamashita Unifocalization and systemic – to
– pulmonary shunt using internal mammary artery for tetralogy of Fallot and pulmonary atresia with diminutive
pulmonary artery and arborization anomaly. J Cardiovasc Surg (Torino) 1997 Oct; 38(5):527-9.
6- Sakai T, Ueda Y, Ogino H, Morioka K.Remarkable growth of the internal mammary artery used for systemic-topulmonary
artery shunt in a patient with cyanotic heart disease. Eur J Cardiothorac Surg 1997 Sep; 12(3):497-500.
7- Kikuchi S, Kashino R, Abe T. Use of internal thoracic artery as a systemic-pulmonary artery shunt. Ann Thorac Surg
1997 Sep; 64:847-9.
8- Takahashi K, Odagiri S, Nagao K. [Systemic-to-pulmonary artery shunt using the internal thoracic artery] Kyobu
Geka 1996 Aug; 49(9):771-3.
9- Thomka I, Sarkozy K, Szedo F, Kelemen K, Szatmari A, Piskothy A. the use of an internal mammary artery for
creating a systemic-to-pulmonary artery shunt. Eur J Cardiothorac Surg 1996; 10(11):1024-6.
9- Yoshimura N, Yamaguchi M, Ohashi H, Imai Oshima Y, Hosokawa Y, Tachibana H. Long-term palliation after
systemic-to-pulmonary artery shunt using an internal mammary artery. Ann Thorac Surg 1993 Aug; 56(2):361-3.
10- Gregoric ID, Reul GJ, Nihill MR. Creation of a systemic-to-pulmonary artery shunt by use of an internal mammary
artery. J card Surg 1993 May; 8(3):358-64.
11- Mckay R.Sequel of the internal mammary artery as a systemic-to-pulmonary artery shunt. Ann Thorac Surg1990
Feb; 49(2):341.
12- Longaker MT, Merrick S, Cromblehholme TM, Langer JC, Verrier ED, Turley K. Systemic-to-pulmonary artery
shunt using the internal mammary artery. Ann Thorac Surg 1989 Mar; 47(3):464-5.