Repair of tetralogy of Fallot in an adult; the importance of preoperative examination for major aorto-pulmonary collateral arteries
Miyahara, K.; Maeda, M.; Sakurai, H.; Nakayama, M.; Murayama, H.; Hasegawa, H.; Matsushima, M.; Ohashi, N.; Numaguchi, A.; Kojima, N.
Kyobu Geka. Japanese Journal of Thoracic Surgery 55(9): 779-783
2002
ISSN/ISBN: 0021-5252 PMID: 12174623 Document Number: 541579
We report the repair of tetralogy of Fallot in a 51-year-old man. He underwent a left classical Blalock-Taussig (B-T) shunt when he was ten years old. Preoperative angiography showed a patent B-T shunt. Total corrective surgery was performed. Postoperatively, he suffered from left ventricular failure. Re-intubation was required three times. Postoperative catheterization showed excellent correction of the right ventricular system, however, descending aortography revealed a great many aorto-pulmonary collateral arteries, which caused the left ventricular failure. Coil embolization of these 13 collateral arteries was performed and he recovered from the left ventricular failure. We conclude that even in an elderly patient with tetralogy of Fallot, total correction should be performed, since the surgical risk is acceptable and the procedure improves the capacity for physical activity and quality of life. Preoperative examination of collateral arteries is important, especially in elderly patients, and coil embolization should be considered.