End stage treatment of TOF is ?
Ans. is 'b' i.e., Modified BT shunt Tetralogy of fallot: BT shunt/systemic-pulmonary aery (PA) shunts: Classic BT shunt: The subclan aery is anastomosed to the ipsilateral pulmonary aery (PA). This procedure is usually performed in infants older than 3- months; a right-sided shunt is performed in patients with left aoic arch; a left sided shunt is performed for right aoic arch. Modified Blalock-Taussig shunt: A Gore-Tex interposition graft is placed between the subclan aery and the ipsilateral PA. This is the most popular procedure for any age, especially for small infants younger than 3 months of age. A left-sided shunt is preferred for patients with a right aoic arch. The surgical moality rate is I% or less. The Waterston shunt: Anastomosis is performed between the ascending aoa and the right PA; this shunt is no longer performed because of high incidence of surgical complications, which include too large a shunt leading to congestive hea failure (CHF) or pulmonary hypeension, or both, and narrowing and kinking of the right PA causing difficulty at the time of corrective surgery. The Pott-shunt operation: Anastomosis is performed between the descending aoa and the left PA; this shunt is no longer performed. It may result in CHF or pulmonary hypeension, as in the Waterston operation. Moreover, left thoracotomy is required to close the shunt during corrective surgery.
BT shunt
Modified BT shunt
Waterston shunt
Pott - shunt operation