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Ann Thorac Surg 1982;33:400-402
© 1982 The Society of Thoracic Surgeons

Articles

Iatrogenic Right Ventricular Failure in Tetralogy of Fallot Repairs: Reappraisal of a Distressing Problem

P. Michael McFadden, M.D., Walter S. Culpepper, III, M.D., John L. Ochsner, M.D.*

From the Departments of Surgery and Pediatric Cardiology, Ochsner Medical Institutions, New Orleans, LA.

Accepted for publication April 27, 1981.

* Address reprint requests to Dr. Ochsner, Ochsner Clinic, 1514 Jefferson Hwy, New Orleans, LA 70121.

A patient with tetralogy of Fallot experienced isolated right ventricular failure when the right coronary artery was occluded by an encircling suture at the time of closure of the ventricular septal defect. Recognition and correction of the problem allowed weaning from cardiopulmonary bypass and an uneventful recovery.

Because ventricular septal defects in tetralogy of Fallot are usually anterior and subaortic, injury to the right coronary artery, in close proximity to the superior aspect of the defect, is a potential danger. When isolated right ventricular failure occurs immediately after repair, suture occlusion of the right coronary artery should be considered as a possible cause.






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