{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T12:51:37Z","timestamp":1769086297159,"version":"3.49.0"},"reference-count":12,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T00:00:00Z","timestamp":1768867200000},"content-version":"vor","delay-in-days":27,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Pseudoaneurysm is a rare but life-threatening complication of the modified Blalock\u2013Taussig\u2013Thomas shunt (mBTTS). We report a 3-year-old girl with pulmonary atresia and ventricular septal defect who underwent staged bilateral mBTTS and presented three months later with fever, acute respiratory distress, and worsening cyanosis. Initial findings suggested severe pneumonia, with right lower-lobe consolidation and abnormal mediastinal contour on chest radiography. Echocardiography and computed tomography angiography revealed a massive, thrombosed pseudoaneurysm of the right subclavian artery at the mBTTS anastomosis, complete thrombosis of the right pulmonary artery, right lung collapse, and concomitant pneumonia. Additional findings included left isomerism and a horseshoe kidney. Despite urgent broad-spectrum antibiotics and referral for emergency surgery, the child rapidly deteriorated and died before intervention. This case emphasizes the need for high clinical suspicion and early advanced imaging in post-mBTTS patients presenting with sepsis or cardiorespiratory compromise.<\/jats:p>","DOI":"10.1093\/jscr\/rjaf1086","type":"journal-article","created":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T12:46:08Z","timestamp":1766493968000},"source":"Crossref","is-referenced-by-count":0,"title":["Fatal pseudoaneurysm of the subclavian artery secondary to infected modified Blalock\u2013Taussig\u2013Thomas shunt: a case report"],"prefix":"10.1093","volume":"2026","author":[{"given":"Mourad","family":"Boukheloua","sequence":"first","affiliation":[{"name":"Faculty of Medicine, University of Health Sciences, Moudjahid Doctor Youcef El Khatib , Road 8 Lieutenant Mohamed Benarfa El Biar 16000, Algiers ,","place":["Algeria"]},{"name":"Cardiology Department, Hussein-Dey Nafissa Hammoud University Hospital Center , Road 94 Boudjemaa Moghni, Hussein-Dey 16005, Algiers ,","place":["Algeria"]},{"name":"Department of Physiology and Molecular Biology, University of Sciences and Technology Houari Boumediene , BP 32 Bab Ezzouar 16111, Algiers,","place":["Algeria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3448-9946","authenticated-orcid":false,"given":"Yehya","family":"Khlidj","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Health Sciences, Moudjahid Doctor Youcef El Khatib , Road 8 Lieutenant Mohamed Benarfa El Biar 16000, Algiers ,","place":["Algeria"]},{"name":"Department of Physiology and Molecular Biology, University of Sciences and Technology Houari Boumediene , BP 32 Bab Ezzouar 16111, Algiers,","place":["Algeria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aziza","family":"Baali","sequence":"additional","affiliation":[{"name":"Medical Imaging and Radiology Department, Zeralda Burns Center , Zeralda 16063, Algiers ,","place":["Algeria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Selma","family":"Aroua","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Health Sciences, Moudjahid Doctor Youcef El Khatib , Road 8 Lieutenant Mohamed Benarfa El Biar 16000, Algiers ,","place":["Algeria"]},{"name":"Cardiology Department, Hussein-Dey Nafissa Hammoud University Hospital Center , Road 94 Boudjemaa Moghni, Hussein-Dey 16005, Algiers ,","place":["Algeria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed","family":"Berrehal","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Health Sciences, Moudjahid Doctor Youcef El Khatib , Road 8 Lieutenant Mohamed Benarfa El Biar 16000, Algiers ,","place":["Algeria"]},{"name":"Cardiology Department, Hussein-Dey Nafissa Hammoud University Hospital Center , Road 94 Boudjemaa Moghni, Hussein-Dey 16005, Algiers ,","place":["Algeria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9457-9832","authenticated-orcid":false,"given":"Mohamed","family":"Rifai","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Menoufia University , Gamal Abd El Nasr st Shebin El-Koum 32511 Menoufia ,","place":["Egypt"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,1,20]]},"reference":[{"key":"2026012010422987300_ref1","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1016\/S0022-5223(97)70113-2","article-title":"The modified blalock-taussig shunt: clinical impact and morbidity in fallot's tetralogy in the current era","volume":"114","author":"Gladman","year":"1997","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2026012010422987300_ref2","doi-asserted-by":"publisher","first-page":"642","DOI":"10.1016\/j.athoracsur.2011.02.030","article-title":"Risk factors for mortality and morbidity after the neonatal Blalock-Taussig shunt procedure","volume":"92","author":"Petrucci","year":"2011","journal-title":"Ann Thorac Surg"},{"key":"2026012010422987300_ref3","doi-asserted-by":"publisher","first-page":"1499","DOI":"10.1016\/S0003-4975(00)01078-X","article-title":"Systemic pulmonary shunts in neonates: early clinical outcome and choice of surgical approach","volume":"69","author":"Alkhulaifi","year":"2000","journal-title":"Ann Thorac Surg"},{"key":"2026012010422987300_ref4","doi-asserted-by":"publisher","first-page":"1096","DOI":"10.1093\/ejcts\/ezt172","article-title":"Modified Blalock Taussig shunt: a not-so-simple palliative procedure","volume":"44","author":"Dirks","year":"2013","journal-title":"Eur J Cardiothorac Surg"},{"key":"2026012010422987300_ref5","doi-asserted-by":"publisher","first-page":"653","DOI":"10.1016\/j.athoracsur.2011.04.008","article-title":"A comparison of Blalock-Taussig shunts with and without closure of the ductus arteriosus in neonates with pulmonary atresia","volume":"92","author":"Zahorec","year":"2011","journal-title":"Ann Thorac Surg"},{"key":"2026012010422987300_ref6","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1510\/icvts.2010.237024","article-title":"Acute and late obstruction of a modified Blalock-Taussig shunt: a two-center experience in different catheter-based methods of treatment","volume":"11","author":"Moszura","year":"2010","journal-title":"Interact Cardiovasc Thorac Surg"},{"key":"2026012010422987300_ref7","doi-asserted-by":"publisher","first-page":"1173","DOI":"10.1016\/0002-8703(90)90133-I","article-title":"Balloon angioplasty of stenosed Blalock-Taussig anastomosis: role of balloon-on-a-wire in dilating occluded shunts","volume":"120","author":"Rao","year":"1990","journal-title":"Am Heart J"},{"key":"2026012010422987300_ref8","doi-asserted-by":"publisher","first-page":"256","DOI":"10.1161\/01.cir.92.9.256","article-title":"Sternotomy approach for the modified Blalock-Taussig shunt","volume":"92","author":"Odim","year":"1995","journal-title":"Circulation."},{"key":"2026012010422987300_ref9","doi-asserted-by":"publisher","first-page":"586","DOI":"10.1016\/1010-7940(92)90131-G","article-title":"Twelve-year experience with the modified Blalock-Taussig shunt in neonates","volume":"6","author":"Fermanis","year":"1992","journal-title":"Eur J Cardiothorac Surg"},{"key":"2026012010422987300_ref10","doi-asserted-by":"publisher","first-page":"206","DOI":"10.1177\/2150135118822463","article-title":"Pseudoaneurysm and arteriovenous fistula after modified Blalock-Taussig shunt: a case series and systematic review","volume":"10","author":"Dorobantu","year":"2019","journal-title":"World J Pediatr Congenit Heart Surg"},{"key":"2026012010422987300_ref11","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1161\/CIRCULATIONAHA.106.652172","article-title":"Clinical outcomes of palliative surgery including a systemicto-pulmonary artery shunt in infants with cyanotic congenital heart disease: does aspirin make a difference?","volume":"116","author":"Li","year":"2007","journal-title":"Circulation"},{"key":"2026012010422987300_ref12","doi-asserted-by":"publisher","first-page":"e65","DOI":"10.1016\/j.jcin.2013.10.026","article-title":"Endovascular management of Blalock-Taussig shunt complications","volume":"7","author":"Mallula","year":"2014","journal-title":"JACC Cardiovasc Interv"}],"container-title":["Journal of Surgical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jscr\/article-pdf\/2026\/1\/rjaf1086\/66476452\/rjaf1086.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jscr\/article-pdf\/2026\/1\/rjaf1086\/66476452\/rjaf1086.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T15:42:38Z","timestamp":1768923758000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jscr\/article\/doi\/10.1093\/jscr\/rjaf1086\/8431556"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,24]]},"references-count":12,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,12,24]]}},"URL":"https:\/\/doi.org\/10.1093\/jscr\/rjaf1086","relation":{},"ISSN":["2042-8812"],"issn-type":[{"value":"2042-8812","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,1]]},"published":{"date-parts":[[2025,12,24]]},"article-number":"rjaf1086"}}