Homograft saphenous vein versus polytetrafluoroethylene graft for modified Blalock -Taussig shunt

Back ground: Modified Blalock-Taussig shunt is an important initial palliation in a selected subset of patients. This randomized controlled study was conducted to evaluate and compare PTFE and homograft saphenous vein as a conduit for this purpose. Patients and Methods: Thirty patients were prospectively randomized to receive either a Polytetrafluoroethylene (PTFE) or an antibiotic preserved homograft saphenous vein as conduit. Early results were analysed and compared. Results: Mean graft size was 3.93 mm±0.53 and 4.2 mm±0.53 in the PTFE and vein group respectively. There were 3 hospital deaths in the vein group and none in the PTFE group. There were 2 early and no late shunt thromboses in PTFE group while 1 early and 2 late thrombosis occurred in vein group. These differences were statistically insignificant. The incidence of post-operative bleeding, peri-graft seroma and operative time was less in vein then PTFE group. Palliation on follow-up was comparable in both groups. Conclusion: This study failed to demonstrate any benefit of homograft saphenous vein over PTFE graft in terms of thrombotic complications and mortality. There was however less bleeding and peri-graft seroma formation in the Saphenous vein (SVG) group. Further studies with greater number of patients and longer follow-up are required to demonstrate the superiority of either of these conduits.