The Blalock–Taussig Shunt 1944 – Treating Blue Baby Syndrome

Describing the hopeless nature of blue baby syndrome at Johns Hopkins Hospital in the 1930s, when surgical treatments were not available, Dr. Sherwin B. Nuland writes:

“An afternoon in the pediatric cardiology clinic was a test of even the most patient physician's patience. The clinic was full of underdeveloped children who fainted at the slightest movement because of breathlessness. Their noses, ears, limbs and sometimes their entire bodies were covered in cyanosis (a bluish-purple discoloration of areas such as the fingertips, lips and beneath the nails). They squatted on the floor or lay motionless on examination tables to avoid worsening their hunger for air.”

Tetralogy of Fallot is one of the common causes of blue baby syndrome. Babies with this heart defect have low blood oxygen levels because a hole in the wall that normally separates the left and right ventricles allows oxygenated and deoxygenated blood to mix in the heart's left ventricle. In addition, a narrowing near the pulmonary valve reduces blood flow into the pulmonary arteries, which carry blood from the heart to the lungs.

The American cardiologist Helen Taussig worked with the American surgeon Alfred Blalock and his assistant Vivien Thomas to investigate whether additional blood could be supplied to the lungs for oxygenation in babies with blue baby syndrome.

In 1944, the operation was performed on a 15-month-old girl, and thousands of lives have been saved since then. Blalock connected the subclavian artery to the pulmonary artery (today, the procedure may use an artificial tube). Thomas had performed the operation on more than 200 dogs before the first attempt on the little girl.

The Blalock–Taussig shunt marked the beginning of the modern era of cardiac surgery. With the advent of open-heart surgery, surgeons could open the heart directly and repair its defects, for example by closing the hole in the internal heart wall with a Gore-Tex patch. As a result, the Blalock–Taussig shunt has become less frequently used.

About the Article Image: A diagram showing a ventricular septal defect (the hole between the right and left sides of the heart, marked with a yellow dot).

Historical Figures Mentioned in the Article: Helen Brooke Taussig (1898 – 1986), Alfred Blalock (1899 – 1964), Vivien Theodore Thomas (1910 – 1985)

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