Unveiling prognostic factors in neonatal modified Blalock-Taussig shunt procedures: a comprehensive single-center analysis
Revista da Associacao Medica Brasileira, cilt.72, sa.4, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 72 Sayı: 4
- Basım Tarihi: 2026
- Doi Numarası: 10.1590/1806-9282.20252127
- Dergi Adı: Revista da Associacao Medica Brasileira
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE
- Anahtar Kelimeler: Heart defects, congenital. Infant, newborn. Cardiac surgical procedures. Riskfactors. Mortality
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
OBJECTIVE: The aim of this study was to describe early outcomes after neonatal modified Blalock-Taussig shunt and identify perioperative predictors of mortality in a tertiary congenital cardiac center. METHODS: In this retrospective cohort, 129 neonates with critical congenital heart disease who underwent modified Blalock-Taussig shunt were analyzed. Demographic, clinical, and perioperative variables were collected, and multivariate logistic regression was used to identify independent predictors of neonatal mortality. RESULTS: Overall neonatal mortality was 21.7%. Shunt failure occurred in 18.9% (24/127) of neonates transferred to the neonatal intensive care unit and was strongly associated with mortality (66.7 vs. 11.6%; p=0.001). Independent risk factors for neonatal mortality included lower gestational age (OR 0.82, 95%CI 0.72–0.94; p=0.004), preoperative inotropic support (OR 3.46; p=0.006), preoperative mechanical ventilation (OR 4.28; p=0.001), shunt failure (OR 5.12; p=0.001), and postoperative metabolic acidosis (OR 6.78; p=0.001). CONCLUSION: Neonates undergoing modified Blalock-Taussig shunt remain at high risk for postoperative complications and death. Preoperative hemodynamic instability, shunt failure, and postoperative metabolic acidosis are strong predictors of poor outcome. These findings support vigilant perioperative monitoring and individualized management strategies in neonatal modified Blalock-Taussig shunt candidates.