A Long-term unrepaired Fallot tetralogy survivor treated only with a
Classical Blalock-Taussig Shunt
Abstract
Tetralogy of Fallot (TOF) is the most common etiology of congenital
cyanotic heart disease, and Blalock-Taussig shunt (BTS) operation is
considered the first-step management to maintain pulmonary blood flow in
TOF patients. Complete repair of TOF is the standard surgical treatment
that should be performed in infancy or early childhood for improved
long-term survival. However, the prognosis of TOF patients treated by
only palliative operation remains uncertain. We report a man with TOF
underwent classic BTS operation at 2 years of age. Despite no
medication, he had a long asymptomatic life. At 53 years of age, he
started to complain of dizziness and recurrent attacks of syncope due to
complete heart block (CHB) and inserted a permanent pacemaker. 2D and 3D
Echocardiography showed uncorrected TOF with an overriding aorta, two
ventricular septal defects (VSDs) were seen; a large inlet type VSD and
another small muscular one with marked right ventricular hypertrophy
with marked infundibular stenosis. Cardiac Computed Tomography (Cardiac
CT) showed TOF with noted severely stenotic right ventricular outflow
tract and pulmonary flow was maintained through a patent classical BTS
between left subclavian artery (SCA) and the left pulmonary artery
(LPA). Due to his stable condition, he was discharged on close up
follow-up visits.