REVIEW article
Front. Pediatr.
Sec. Pediatric Cardiology
This article is part of the Research TopicInnovations in Congenital Heart Disease: Cutting-Edge Approaches to Diagnoses and ManagementView all 4 articles
Systemic-to-pulmonary artery shunt: a surgical strategy with no expiration date
Provisionally accepted
- Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Mexico City, Mexico
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Background Systemic‑to‑pulmonary shunts remain a fundamental surgical option in the palliative management of complex congenital heart defects, particularly in patients with univentricular physiology. Although technically demanding, the procedure has evolved through multiple modifications aimed at simplifying its execution and reducing complications, while maintaining its essential clinical role. Objective To provide a narrative review of the Blalock‑Taussig‑Thomas shunt, examining its physiological basis, surgical technique, associated risks and complications, postoperative management, and historical evolution, with the goal of evaluating its continued relevance in the palliative treatment of complex congenital heart defects. Methods A literature search was conducted in Elsevier, PubMed, and Scopus using the keyword "systemic‑to‑pulmonary shunt." Studies addressing historical development, technical evolution, clinical indications, and postoperative outcomes were included. The review focused on pediatric populations, specifically prenatal, neonatal, and school‑age patients. Studies involving adolescents were excluded to maintain consistency with early developmental stages and the typical clinical context in which these shunts are used. Results & Conclusion The systemic‑to‑pulmonary shunt remains a valuable and widely used palliative technique for patients with complex congenital heart defects and univentricular physiology. While the original Blalock‑Taussig‑Thomas technique has historically shown favorable outcomes,
Keywords: congenital heart disease, palliative cardiac surgery, pulmonary ductal stent, systemic to pulmonary artery shunt, univentricular heart
Received: 13 Dec 2025; Accepted: 13 Feb 2026.
Copyright: © 2026 Ruiz. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Luis Ruiz
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