J.Jpn. Surg. Soc.. 80(11): 1245-1249, 1979

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Report on the annual meeting

OPERATIVE TREATMENT OF TETRALOGY OF FALLOT

The operative treatment of tetralogy of Fallot in fourty six patients who received total correction under profound hypothermia and circulatory arrest in combination with surface and core cooling was described.
The profound hypothermia is performed under deep ether anesthesia. After 1 to 2 mg per kg of phenoxybenzamine is infused, norepinephrine (0.5 to 1.0 μg/kg/min) is continuously infused throughout the cooling period to maintain an adequate hemodynamic state. The patient is cooled by surface cooling until the esophageal temperature reaches 24 to 25 °C, and is further cooled by means of pump oxygenator to about 17 °C. Intracardiac procedure is performed under circulatory arrest which usually ranges from 60 to 70 minutes. Rewarming is made by means of pump oxygenator until the esophageal temperature reaches around 32 °C, and further with immersion rewarming.
Our operative methods of total correction of this anomaly mainly consists of widening of the hypoplastic pulmonary annulus and the main pulmonary artery rather than extensive excision of the infundibular muscle bands. The ventricular septal defect is closed with a Dacron Velour patch anchored in place with 3-0 Ticron sutures in an intermittent mattress fashion.

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