The effect of alteration of systemic pressure upon peripheral arterial oxygen saturation was studied in patients with congenital heart disease. Vasodepression produced by amyl nitrite caused a fall in systemic oxygen saturation in five patients with tetralogy of Fallot, two with patent duetus arteriosus and severe pulmonary hypertension, and one with Eisenrnenger's complex. These changes did no...

The ultimate aim of surgical treatment of Fallot's tetralogy is complete anatomic repair by removal of the obstruction to pulmonary blood flow and closure of the ventricular septal defect. This ideal has been achieved by a small number of surgeons using a pump oxygenator and cardiac arrest. Until it can be realized by all, less complete operations will be performed that will improve the conditi...

The recent introduction by Blalock (1) of an operative procedure for the successful treatment of the tetralogy of Fallot has focused considerable attention on the various manifestations of this condition. It has also indicated the need of more information to aid in the diagnosis and prognosis, as well as in the preoperative and postoperative treatment of the patients with this disease. The pres...

DR. AUSTIN: Well, I want to thank everybody for attending. As you may know, less than a year ago I was privileged to become a coeditor for Seminars in Thoracic and Cardiovascular Surgery, as it was thought that some input from a congenital heart surgeon would be helpful. If you look at Seminars over the past several years there have been discussions on various topics which have been primarily a...

Experience with the first 100 cases with tetralogy of Fallot subjected to intracardiae repair are presented. In this series there was an early hospital mortality of 12 per cent and 6 late deaths occurred. Eighty out of 82 survivors were available for follow-up and 33 of these underwent postoperative catheterization studies. The functional status of the survivors revealed excellent results in 89...

This paper reviews the available literature on normal fetal and transitional circulation and its importance in understanding the abnormal circulation related to tetralogy of Fallot (TOF). The anatomical defects of TOF are described along with the clinical manifestations related to each defect. Surgical management and risk factors, which play a major role in the anesthetic management of these pa...

We present the case of a 3-month-old girl who had unrepaired Tetralogy of Fallot who presented to the emergency department with an acute hypoxic episode. The patient was hyperpneic and cyanotic, with an initial oxygen saturation of 56%. She did not respond to knee-to-chest positioning. A single dose of intranasal fentanyl was administered with subsequent resolution of her symptoms and improveme...

A 7 year old boy with a history of repaired tetralogy of Fallot with aortic valve replacement was scheduled to undergo laparoscopic cholecystectomy. His significant history comprises of post cardiac surgery with warfarin anticoagulant. Perioperatively warfarin was converted to low molecular weight heparin and the patient underwent general endotracheal anaesthesia with caudal epidural anaesthesi...

A case of tetralogy of Fallot is described, in which thrombotic obstruction of the superior vena cava developed after total correction. Partial thrombolysis was achieved with streptokinase therapy.