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.