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Eduardo Arciniegas
Eugene H. Blackstone
Albert D. Pacifico
John W. Kirklin
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Ann Thorac Surg 1979;27:514-518
© 1979 The Society of Thoracic Surgeons

Articles

Classic Shunting Operations as Part of Two-Stage Repair for Tetralogy of Fallot

Eduardo Arciniegas, M.D., Eugene H. Blackstone, M.D., Albert D. Pacifico, M.D., John W. Kirklin, M.D.*

From the Departments of Surgery, Children's Hospital of Michigan, Detroit, MI, and the University of Alabama School of Medicine and Medical Center, Birmingham, AL

Accepted for publication October 16, 1978.

* Address reprint requests to Dr. Kirklin, Department of Surgery, University Station, Birmingham, AL 35294

One hundred forty-nine consecutive patients with tetralogy of Fallot, with or without pulmonary atresia, underwent Blalock-Taussig or Waterston operation for initial palliation. Of these patients, 45 were less than 6 months old, and 63 were less than 1 year old. The type of shunt, and the presence or absence of pulmonary atresia did not have a significant effect (p > 0.2) on hospital mortality. Parametric analysis showed a significant effect of age (p = 0.03), the risk of hospital death being 6% at 1 month of age, 4% at 3 months, 3% at 6 months, and 2.5% at 12 months. No late deaths occurred before the age of 3 years. Six patients (4.2% of the hospital survivors) required another operation before they were 3 years old. Severe arm ischemia occurred after a Blalock-Taussig shunt in 1 infant with Down's syndrome.




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