Hybrid approach for postclassical blalock–Taussig shunt tetralogy

In developing countries, we still come across occasional patients who have undergone classic Blalock–Taussig shunt (CBTS) previously. We present a case of 23-year-old female with tetralogy of Fallot who had undergone CBTS operation at the age of 1 year and is now presented for total correction. Takedown of CBTS during surgery has catastrophic complications during looping and ligation of shunt due to extensive collateralization. We, therefore, took a hybrid approach for the patient. The CBTS was first blocked with the balloon, followed by surgical intracardiac repair, and finally, by device closure of CBTS.