The modified BT shunt uses a vascular graft (typically Gore-Tex [W. L. Gore and Associates, Elkton, MD]) that shunts blood from the subclavian or brachiocephalic artery to the ipsilateral main pulmonary artery. It often is used as a palliative procedure to increase pulmonary flow and expand the pulmonary arteries before more definitive surgery. The modified shunt differs from the original procedure, which is performed without a graft.

The Glenn shunt is a vascular conduit that shunts blood from the superior vena cava (SVC) to the right pulmonary artery. It is used in a staged palliative procedure in patients with single-ventricle physiology. Eventually, a more definitive Fontan shunt is performed to also supply blood from the inferior vena cava (IVC) to the pulmonary arteries. Glenn shunts typically are performed at 3–9 months of age, when pulmonary vascular resistance has decreased. If a left SVC also is present, bilateral bidirectional Glenn shunts are performed.

The Fontan procedure involves the placement of a vascular shunt that channels blood from the IVC to the pulmonary artery. It is the final procedure for patients with single-ventricle physiology to provide definitive blood flow to the pulmonary arteries. The surgery may be intra-atrial, in which a tunnel is created to channel blood to the pulmonary arteries, or extra-atrial in which a synthetic graft is placed to connect the IVC to the pulmonary arteries.

The hybrid procedure typically is performed for palliation in patients with hypoplastic left heart syndrome who may not be candidates for a stage I Norwood procedure. In the hybrid procedure, which does not require cardiopulmonary bypass, a vascular stent is placed in the patent ductus arteriosus (PDA) while bilateral pulmonary banding is performed to limit pulmonary blood flow.