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The letter contextualizes findings within evolving congenital surgery trends toward early total correction rather than staged palliation.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/comment-to-the-article-is-the-modified-blalock-taussig-shunt-becoming-obsolete/445519/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/comment-to-the-article-is-the-modified-blalock-taussig-shunt-becoming-obsolete/445519.png","ImageObject",300,407,{"name":42,"@type":43},"Lucas Martin","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-11-04","2026-09-29",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",9,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What systematic review does the letter discuss?","Question",{"text":63,"@type":64},"The letter discusses a recent systematic review and meta-analysis by Ikhwani et al. that consolidates data on complications and outcomes related to the modified Blalock-Taussig-Thomas (mBT) shunt.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"Which complications associated with the mBT shunt are emphasized?",{"text":68,"@type":64},"It highlights early shunt thrombosis, distortion of pulmonary arteries, shunt overcirculation, and phrenic nerve palsy, especially in neonates and infants.",{"name":70,"@type":61,"acceptedAnswer":71},"Why might the mBT shunt become obsolete in routine practice?",{"text":72,"@type":64},"The letter argues that modern congenital cardiac surgery increasingly favors early total correction over staged palliation, reducing the need for interim shunt placement, so mBT shunts may be reserved for highly selected cases.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},445519,1791092189,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,119,122,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":55,"doc_module":4,"doc_module_name":25,"category_name":116,"show_sort_weight":117,"slug":118},"Religion & Spirituality",20,"religion-spirituality",{"id":117,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":117,"slug":121},"World Cup","world-cup",{"id":123,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":123,"slug":125},10,"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":97,"slug":129},19,"General","general",{"code":4,"msg":82,"data":131},{"doc_id":79,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":22,"language":139,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":12,"update_tm":143,"read_time":30,"preview_page_count":4},8796095360427,"https://ap-avatar.wpscdn.com/davatar_994ba38a5ba835b3df7d355c54d3ed8d","Turkish Journal of Thoracic and Cardiovascular Surgery 2025;33(4):587  \nLetter to the Edıtor / Editöre Mektup  \nComment to the article: Is the modified Blalock-Taussig shunt becoming obsolete?  \nMakaleye yorum: Modifiye Blalock-Taussig şantı gözden mi düşüyor?  \nKhaled Alebrahim􀀬  \nDepartment of Surgery, King Abdulaziz University, Jeddah, Saudi Arabia  \nI read with great interest the recent systematic review and meta-analysis by Ikhwani et al. [1] The authors have undertaken a valuable effort to consolidate data regarding complications and outcomes associated with the modified BlalockTaussig-Thomas (mBT) shunt, a procedure that has played a crucial role in the palliative management of cyanotic congenital heart diseases for decades .  \nNonetheless, it is of utmost importance to contextualize these findings within the current trends in congenital heart surgery. The complications highlighted in the article, namely, early shunt thrombosis, distortion of pulmonary arteries, and shunt overcirculation, phrenic nerve palsy, continue to pose significant risks, particularly in neonates and infants . These complications often necessitate urgent reintervention and are associated with increased perioperative mortality. [2,3]  \nIn recent years, there has been a decisive shift in surgical strategy favoring early total correction over staged palliation in many cyanotic congenital cardiac lesions . Advances in neonatal anesthesia, cardiopulmonary bypass techniques, and perioperative care have allowed for primary biventricular or univentricular repair in infancy, thereby eliminating the need for interim shunt placement in a growing number of cases . This evolution reflects a broader trend away from reliance on mBT shunts, which are increasingly viewed as a historical bridge rather than a current standard. [4,5]  \nIkhwani et al.’s[1] findings, while valuable, may underscore the limited contemporary role of the  \nmBT shunt, which is now predominantly reserved for highly selected cases where early correction isnot feasible. As such, this procedure may soon be considered obsolete in routine congenital cardiac surgery.  \nData Sharing Statement: The data that support the findings of this study are available from the corresponding author upon reasonable request.  \nConflict of Interest: The author declared no conflicts of interest with respect to the authorship and/or publication of this article.  \nFunding: The author received no financial support for the research and/or authorship of this article.  \nREFERENCES  \n1. Ikhwani AD, Rayhan A, Wardoyo S. Modified BlalockTaussig-Thomas shunt blockage and mortality: A systematic reviewandmeta-analysis.TurkGogusKalpDama2025;33:587- 587. doi: 10.5606/tgkdc.dergisi.2025.26521 .  \n2. Petrucci O, O'Brien SM, Jacobs ML, Jacobs JP, Manning PB, Eghtesady P. Risk factors for mortality and morbidity after the neonatal Blalock-Taussig shunt procedure. Ann Thorac Surg 2011;92:642-51 . doi: 10.1016/j.athoracsur.2011.02.030 .  \n3. Al-Ebrahim KE, Elassal AA, Eldib OS, Abdalla AHA, Allam ARA, Al-Ebrahim EK, et al. Diaphragmatic palsy after cardiac surgery in adult and pediatric patients. Asian Cardiovasc Thorac Ann 2019;27:481-5 . doi: 10. 1177/0218492319859806 .  \n4. Anderson BR, Caceres M, Torres A. Contemporary outcomes of neonatal cardiac surgery: A comparison between palliative and corrective procedures. J Thorac Cardiovasc Surg 2018;155:2145-53 .  \n5. Al-Ebrahim EK, Madani TA, Al-Ebrahim KE. Future of cardiac surgery, introducing the interventional surgeon. J Card Surg 2022;37:88-92 . doi: 10.1111/jocs.16061 .  \nCorresponding author: Khaled Alebrahim.  \nE-mail: [dr.k.ebrahim@gmail.com](dr.k.ebrahim@gmail.com)  \n[Doi: 10.5606/tgkdc.dergisi.2025.28426](Doi: 10.5606/tgkdc.dergisi.2025.28426)  \n[Received:](Received: August 06)[ August 06](Received: August 06) , 2025  \nAccepted: September 24, 2025  \nPublished online: October 20, 2025  \nCite this article as: Alebrahim A. Comment to the article: Is the modified Blalock-Taussig","cbCaigT3BiIQkzS7","https://ap.wps.com/l/cbCaigT3BiIQkzS7","pdf",138576,"English","# Letter to the Editor\n## Context of the findings and clinical risks\n## Shift toward early total correction in congenital surgery\n## Data sharing, conflict of interest, and funding","[{\"question\":\"What systematic review does the letter discuss?\",\"answer\":\"The letter discusses a recent systematic review and meta-analysis by Ikhwani et al. that consolidates data on complications and outcomes related to the modified Blalock-Taussig-Thomas (mBT) shunt.\"},{\"question\":\"Which complications associated with the mBT shunt are emphasized?\",\"answer\":\"It highlights early shunt thrombosis, distortion of pulmonary arteries, shunt overcirculation, and phrenic nerve palsy, especially in neonates and infants.\"},{\"question\":\"Why might the mBT shunt become obsolete in routine practice?\",\"answer\":\"The letter argues that modern congenital cardiac surgery increasingly favors early total correction over staged palliation, reducing the need for interim shunt placement, so mBT shunts may be reserved for highly selected cases.\"}]","Comment to the article - Is the modified Blalock-Taussig shunt becoming obsolete? | PDF",1790712322]