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June 1961

Complete Correction of Tetralogy of Fallot: Use of the Combination of Cardiopulmonary Bypass and Deep Hypothermia

Author Affiliations

Surgical Association, Detroit, Dec. 1, 1960.; From the Departments of Pediatrics and Surgery, Stanford University School of Medicine, Stanford, Calif., and the San Francisco Institute of Medical Sciences, Presbyterian Medical Center.

Arch Surg. 1961;82(6):793-800. doi:10.1001/archsurg.1961.01300120007002

The congenital malformation known as tetralogy of Fallot was the first cardiac lesion to be treated successfully by cardiopulmonary bypass. Nevertheless, in the surgical correction of the common congenital lesions of the heart, the treatment of tetralogy has been beset with many problems, and at the present time it remains the lesion in which consistent success is most difficult to predict. Our experience and slow progress toward an understanding of the difficulties is perhaps mirrored by many groups in different parts of the world. We have analyzed the 66 patients operated upon for this condition in this unit, and, in particular, we have attempted to assess objectively the reasons why 23 of these patients died.

Definition  In the original description, 4 abnormalities were noted—pulmonic stenosis, interventricular septal defect, right ventricular hypertrophy, and overriding aorta.1 It is now recognized that the fundamental malformation is the presence of an interventricular septal