PMID: 6169419Sep 1, 1981Paper

Palliative surgery in tetralogy of Fallot

Canadian Journal of Surgery. Journal Canadien De Chirurgie
P H StanleyC Kratz

Abstract

Because much controversy surrounds the palliative surgical treatment of young children with tetralogy of Fallot the authors review their experience over 13 years with two procedures--the Blalock-Taussig operation and the Waterston shunt. Blalock shunts were performed 195 times in 172 patients; 147 had a single Blalock anastomosis which carried them through the critical period and allowed for later correction of the tetralogy. Thrombosis of the Blalock anastomosis occurred in two patients in the early postoperative period. In 23 patients a second shunt was necessary after the first Blalock shunt became inadequate in spite of being patent. The age of the children ranged from 2 weeks to 9 years, 74% being operated upon under the age of 2 years. There were four early deaths (2%) and five late deaths (2.5%) in this group. Of the last 91 consecutive patients operated upon between Sept. 1, 1972 and June 30, 1980 none have died. Between September 1968 and June 1980, 14 patients with tetralogy of Fallot underwent a Waterston shunt. Their ages ranged from 2 days to 4 years. Six patients were younger than 35 days at the time of operation. There were two operative deaths in this group. The Waterston shunt carries a high risk and is reserve...Continue Reading

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