DefinePK

Abstract

Background & objective: The Blalock-Taussig (BT) shunt maintains pulmonary blood flow in patients with congenital heart defects. It is used before corrective surgery to prevent cyanosis and is associated with morbidity and declining survival. This study evaluated survival rates and identified predictors of morbidity and mortality in children who underwent BT shunt surgery at Dr. Cipto Mangunkusumo Hospital, Indonesia, retrospectively.
Methods: This retrospective study included 197 pediatric patients who underwent BT shunt surgery between 2016 and 2020. The patients' ages at the time of surgery ranged from 20 months to 17 years, and their weights varied from 2.7–42 kg. Patients with incomplete medical records were excluded from the study. The primary goal of this study was to evaluate the 5-year survival rate and identify predictors of mortality. The Cox regression test was applied, including factors with P < 0.25 from the bivariate analysis.
Results: Postoperative complications included prolonged mechanical ventilation (> 24 h) in 52% of cases. The survival rate declined from 68% immediately after surgery to 50% at 60 months postoperatively. The significant mortality risk factors included age < 263 days [Hazards Ratio (HR), 3.097], single-ventricle defects (HR, 1.834), low body weight (< 4.25 kg) (HR, 3.802), preoperative prostaglandin use (HR, 2.818), hematocrit levels < 45% (HR, 1.946), and postoperative saturation < 70% (HR, 3.562). Younger age and low saturation levels were associated with higher mortality risk.
Conclusion: The BT shunt, which is critical for children with heart defects, is associated with significant morbidity and decreased survival rates. Key mortality factors include young age, low body weight, prostaglandin use, poor postoperative oxygen saturation, and single ventricle defects. These findings emphasize the need for careful patient selection, surgical planning, and care to optimize survival.
Abbreviations: BT shunt: Blalock-Taussig shunt, CHD: Congenital heart disease, CICU:  Cardiac Intensive Care, UnitHR: Hazards Ratio, SDGs: Sustainable Development Goals, TOF: tetralogy of Fallot,
Keywords: Blalock-Taussig shunt; Cardiac surgery; Congenital heart disease; Morbidity; Mortality; Postoperative outcomes
Citation: Amelia P, Advani N, Djer MM, Lubis B. Survival of Blalock-Taussig shunt surgery in children with congenital heart disease in the postoperative cardiac ICU of a national referral hospital in Jakarta. Anaesth. pain intensive care 2025;29(6):483-91 DOI: 10.35975/apic.v29i6.2891
Received: June 18, 2025; Revised: August 04, 2025; Accepted: August 04, 2025