Vestibulopathy after a modified Blalock-Taussig procedure in a cyanotic congenital heart disease patient

Vestibulopathy is a condition characterized by the onset of vertigo, nausea and vomiting, in the absence of hearing loss or tinnitus. The differential diagnosis includes peripheral otologic disorders and central disorders such as vascular insufficiency. Modified Blalock-Taussig (B-T) shunt, a polytetrafluoroethylene graft from the subclavian artery to the pulmonary artery, has become the palliative procedure of choice in cyanotic congenital heart disease patients. This palliative surgery creates a similar vascular haemodynamic to that seen in the subclavian steal syndrome and when associated with aplasia, hypoplasia or stenosis of the contralateral carotid, vertebral or posterior communicating arteries it may predispose to vascular hypoperfusion and peripheral hypofunctioning of the vestibular system. We report the case of a cyanotic congenital heart disease patient with vertigo and dizziness who underwent a modified B-T fistula on childhood and developed, many years later, a vertiginous syndrome probably of vascular origin.