Blalock–Hanlon procedure

Surgical procedure involving the heart

Blalock–Hanlon procedure
ICD-9-CM	35.42
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The Blalock–Hanlon procedure was created by Alfred Blalock and C. Rollins Hanlon. It was described in 1950.^[1] Alfred Blalock was an American surgeon most known for his work on the Blue Baby syndrome.^[2] C. Rollins Hanlon was also an American surgeon but was best known for his work in cardiology.^[3] The procedure that these two men created, known as the Blalock–Hanlon procedure, was a new concept termed atrial septectomy. This procedure had been experimented on the right atrium of dogs before Dr. Blalock and Dr. Hanlon had performed it on humans.^[4]

It involves the intentional creation of a septal defect in order to alter the flow of oxygenated blood. It was devised as a palliative correction for transposition of the great vessels.

The Blalock–Hanlon procedure was a cardiothoracic procedure created in the 1950s. The Blalock–Hanlon procedure was created to enhance intracardiac combinations.^[5] A majority of the surgeries using this procedure were performed in pediatrics on infants ranging from one day to five months of age.^[5] Of all the children who had this surgery, only one had to undergo a second operation to repair damage not fixed during the Blalock–Hanlon procedure.^[6] According to Behrendt, Orringer, and Stern, there were only ten early deaths out of the forty-eight children the operation was performed on.^[5] The deaths were of children that were less than one month old due to extensive measures taken during the operation.^[5]

The procedure also had a relatively high mortality rate of only twenty-one percent while it was performed however, because of the excessive mortality rate it is no longer used in today's medical society.^[5] This procedure was a combination of two circulations (Pulmonary and Systematic).^[4] Due to the intracardiac mixing, the procedure can cause postoperative arrhythmias, cerebral thrombosis, adhesions develops in the pericardial space, and many infants will face death between the septectomy.^[5]

It was developed by Vivien Thomas at the Hunterian Laboratory ("the dog house") of Johns Hopkins and described by Alfred Blalock and C. Rollins Hanlon.^{[citation needed]}

Surgery

The surgery was performed with the patient first being placed under general anesthesia, throughout the procedure blood gas analyses were performed to detect metabolic acidosis. The surgeon would then make an incision in the right atrium and excised it. If the operation was deemed successful the child would have intubation removed, if and only if the blood gas analyses were acceptable.^{[citation needed]}

While The Blalock–Hanlon procedure seemed successful thirty-five of the forty-eight patients had postoperative conditions that ranged from arrhythmias, low cardiac output, metabolic issues, seizures, congestive heart failure, and phrenic nerve paralysis.^{[citation needed]}

References

^ Catherine A. Neill; Edward B. Clark (28 February 1995). The developing heart: a 'history' of pediatric cardiology. Springer. pp. 61–. ISBN 978-0-7923-3375-3. Retrieved 21 June 2011.
^ Cooper, David Y. (2000). "Blalock, Alfred". American National Biography. Oxford University Press. doi:10.1093/anb/9780198606697.article.1200085.
^ Stoney, William S. (2008). Pioneers of cardiac surgery (1st ed.). Nashville: Vanderbilt University Press. ISBN 978-0-8265-9243-9. OCLC 823170308.
^ ^a ^b Konstantinov, Igor E; Alexi-Meskishvili, Vladimir V; Williams, William G; Freedom, Robert M; Van Praagh, Richard (June 2004). "Atrial switch operation: past, present, and future". The Annals of Thoracic Surgery. 77 (6): 2250–2258. doi:10.1016/j.athoracsur.2003.10.018.
^ ^a ^b ^c ^d ^e ^f Behrendt, Douglas M.; Kirsh, Marvin M.; Orringer, Mark B.; Perry, Burton; Sigmann, Joan; Stern, Aaron; Sloan, Herbert (October 1975). "The Blalock-Hanlon Procedure" (PDF). The Annals of Thoracic Surgery. 20 (4): 424–432. doi:10.1016/S0003-4975(10)64240-3.
^ Cohen, David J.; Chopra, Paramjeet S. (October 1987). "The Blalock-Hanlon Operation: An Anachronism?" (PDF). The Annals of Thoracic Surgery. 44 (4): 407–410. doi:10.1016/S0003-4975(10)63802-7.

Tests and procedures involving the heart

Cardiac surgery
Interventional cardiology
Cardiology diagnostic tests and procedures
Cardiac imaging

Surgery

Heart valves and septa	Valve repair Valvulotomy Mitral valve repair Valvuloplasty aortic mitral Valve replacement Aortic valve repair Aortic valve replacement Ross procedure Transcatheter Mitral valve replacement Transcatheter pulmonary valve replacement production of septal defect in heart enlargement of existing septal defect Atrial septostomy Balloon septostomy creation of septal defect in heart Blalock–Hanlon procedure shunt from heart chamber to blood vessel atrium to pulmonary artery Fontan procedure left ventricle to aorta Rastelli procedure right ventricle to pulmonary artery Sano shunt compound procedures for transposition of the great vessels Arterial switch operation Mustard procedure Senning procedure for univentricular defect Norwood procedure Kawashima procedure shunt from blood vessel to blood vessel systemic circulation to pulmonary artery shunt Blalock–Taussig shunt SVC to the right PA Glenn procedure
Cardiac vessels	CHD Angioplasty Bypass/Coronary artery bypass MIDCAB Off-pump CAB TECAB Coronary stent Bare-metal stent Drug-eluting stent Obstacle removal Endarterectomy Atherectomy Bentall procedure Valve-sparing aortic root replacement LeCompte maneuver
Other	Pericardium Pericardiocentesis Pericardial window Pericardiectomy Myocardium Cardiomyoplasty Dor procedure Septal myectomy Ventricular reduction Alcohol septal ablation Conduction system Maze procedure (Cox maze and minimaze) Catheter ablation Cryoablation Radiofrequency ablation Pacemaker insertion S-ICD implantation ICD implantation Cardiac resynchronization therapy Left atrial appendage occlusion Cardiotomy Heart transplantation