This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by PACIFICO, A. D. Articles by KIRKLIN, J. W. Search for Related Content PubMed PubMed Citation Articles by PACIFICO, A. D. Articles by KIRKLIN, J. W.

(Circulation. 1973;48:1085.)
© 1973 American Heart Association, Inc.

---

Primary Total Correction of Tetralogy of Fallot in Children Less Than Four Years of Age

ALBERT D. PACIFICO M.D.¹; L. M. BARGERON Jr. M.D.¹; JOHN W. KIRKLIN M.D.¹

¹ From the Departments of Surgery and Pediatric Cardiology, School of Medicine and the Medical Center, University of Alabama in Birmingham, Alabama.

Twenty-two consecutive severely symptomatic infants and small children less than 4 years of age (mean age 25.5 months, range 3 to 48 months) have presented for initial surgical treatment of the tetralogy of Fallot at the University of Alabama Medical Center between September 1, 1971 and January 31, 1973. One was considered unsuitable for complete repair because of massive thrombosis of the inferior vena cava, and was successfully treated by a right Blalock-Taus-sig operation. Twenty-one were treated by primary intracardiac repair. One patient (age 24 months) died, a hospital mortality rate of 4.8%. Mean value for the RV/LV peak pressure ratio immediately after repair was 0.55. An outflow patch was placed across the valve ring in one patient, and should have been placed in one other. Heart block has not occurred. Profound hypothermia and circulatory arrest (Kyoto-Barratt-Boyes technique) was used in 9 patients, and cardiopulmonary bypass with profound hypothermia in 12. We discuss the controversy concerning initial management of infants and small children severely symptomatic from the tetralogy of Fallot, and conclude that primary intracardiac repair is advisable in centers prepared for infant intracardiac surgery.

Key Words: Cardiopulmonary bypass • Hypothermia

Submitted on May 23, 1973
Accepted on July 17, 1973

This article has been cited by other articles:

				J. Caspi, E. Zalstein, N. Zucker, A. Applebaum, L. H. Harrison Jr, N. A. Munfakh, H. A. Heck Jr, T. B. Ferguson Jr, A. Stopa, M. White, et al. Surgical management of tetralogy of fallot in the first year of life Ann. Thorac. Surg., October 1, 1999; 68(4): 1344 - 1348. [Abstract] [Full Text] [PDF]