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February 1966

Tetralogy of Fallot and Pulmonary Hypertension: Complication After Systemic-to-Pulmonary Anastomosis

Author Affiliations

From the Department of Pediatrics and Surgery, University of Cincinnati College of Medicine, and the Cincinnati Children's Hospital.

Am J Dis Child. 1966;111(2):166-177. doi:10.1001/archpedi.1966.02090050098007

PULMONARY hypertension is a rare complication of systemic to pulmonary artery anastomosis for tetralogy of Fallot.1,2 The recognition of this complication is of great importance in the follow-up of patients after shunt procedures so that corrective surgery can be undertaken prior to the development of severe pulmonary vascular disease. The purpose of this study is to suggest the mechanism of pulmonary hypertension, emphasize the difficulty of clinical recognition of this complication, and stress the role of auscultation in the evaluation of pulmonary blood flow and pressure.

Clinical Material  The study comprises 125 patients with tetralogy of Fallot who had a systemic pulmonary artery anastomosis and were observed for a period varying from six months to 16 years. Eighty-five patients had the Blalock-Taussig anastomosis3 and 40 had Potts' operation.4 These patients were divided into the following groups: (a) those who acquired severe pulmonary hypertension after surgery, (b) patients

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