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Late Deterioration in Tetralogy of FallotUnusual Findings and Successful Correction
Ulrich W. Busch, MD;
Virendra S. Mathur, MD;
Efrain Garcia, MD;
Denton A. Cooley, MD;
Carlos M. de Castro, MD;
Robert J. Hall, MD
Arch Intern Med. 1978;138(9):1423-1424.
Abstract
A patient with tetralogy of Fallot who underwent a successful Blalock shunt procedure as a child was evaluated 28 years later because of clinical deterioration. Results of cardiac catheterization and angiography disclosed, in addition to a functioning shunt, evidence of an infundibular, subvalvular tumor and a large anastomosis between the left circumflex coronary artery and the bronchial arteries of the right lung with the possibility of "coronary steal." At operation, the Blalock and coronary-to-bronchial artery anastomoses were ligated; and total correction was performed including resection of the pulmonary valve and infundibulum, excision of the tumor, closure of the ventricular septal defect, and application of an outflow patch to enlarge the pulmonary annulus. The patient was discharged nine days after surgical correction.
(Arch Intern Med 138:1423-1424, 1978)
Author Affiliations
From the Clayton Foundation Cardiovascular Research Laboratory-St Luke's Episcopal Hospital, and the Texas Heart Institute, Houston.
Footnotes
Accepted for publication April 17, 1978.
Reprint requests to Clayton Foundation for Research Cardiovascular Laboratory, St Luke's Episcopal Hospital, PO Box 20269, Houston, TX 77025 (Dr Mathur).
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