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November 1967

Intrapericardial Aortopulmonary Anastomosis for Tetralogy of Fallot: Clinical Experience

Author Affiliations

From the Cora and Webb Mading Department of Surgery, Baylor University College of Medicine, and the Texas Heart Institute of the Texas Children's and St. Luke's Episcopal hospitals, Houston.

Arch Surg. 1967;95(5):709-716. doi:10.1001/archsurg.1967.01330170017003

SURGICAL treatment of tetralogy of Fallot was introduced two decades ago by the pioneer work of Blalock and Taussig.1 They utilized subclavian-pulmonary anastomosis to increase pulmonary blood flow and improve the circulatory dynamics of children with tetralogy. Subsequent development of cardiopulmonary bypass and techniques for correction of this anomaly has not negated the value of an initial palliative operation, especially in newborn infants in whom the risk of open-heart surgery is considerable. A variety of techniques for the creation of systemic-pulmonary anastomoses have been employed. The principal disadvantage of commonly used shunts is the difficulty with which they are dissected and closed at the time of total correction. This report concerns our initial experience with an intrapericardial anastomosis between the ascending aorta and right pulmonary artery in patients with tetralogy of Fallot. Results in patients with this shunt are compared with results in patients undergoing standard Blalock and