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Ann Thorac Surg 1984;37:431-436
© 1984 The Society of Thoracic Surgeons

Articles

The Surgical Treatment of Tetralogy of Fallot

H.E. Sánchez, M.D., D.Sc.*, E.M. Cornish, B.Sc.(Hons), M.B., Ch.B., Feng Chu Shih, M.D., J. de Nobrega, F.R.C.S., J. Hassoulas, M.Med.(Cape Town), J. Netto, M.D., R.E. Thornington, F.F.A.(S.A.), C.N. Barnard, M.D., Ph.D., D.Sc.(Hon Causa)

Cardiac Unit and the Department of Anaesthetics (RET), Groote Schuur Hospital and Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, Republic of South Africa

* Address correspondence to Dr. Sánchez, Department of Cardiac Surgery, Groote Schuur Hospital, Observatory, Cape Town, Republic of South Africa

This is a review of the last 307 patients with tetralogy of Fallot who were operated on in our unit at Groote Schuur Hospital and Red Cross War Memorial Children's Hospital. Complete repair was undertaken in 301 patients, and shunts were performed in 6 children. There were 17 hospital deaths and 1 late death. The mortality was 5.5% for children less than 12 years old and 6.6% in patients between 12 and 20 years old.

During this study period, there was a change in our policy as to when complete repair should be attempted. At present, we perform systemic-pulmonary shunts in patients less than 6 months old and delay complete repair until the child is 2 years old. In deciding whether a shunt should precede complete repair, our experience has shown that age is not as important a consideration as the anatomy of the outflow tract of the right ventricle and pulmonary arteries.




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