Medical Management Of Hypercyanotic Spells In Fallot’s Tetrology

Material and Methods: The study includes 45 patients with TOF who presented with cyanotic spells from amongst 142 TOF patients seen at the Congenital Heart Clinic at National Institute of Cardiovascular Diseases, Karachi, during one year period between October, 1980 to October, 1981. The diagnosis was made on clinical grounds, confirmed byEchocardiography and Cardiac Catheteriz ation and Angiocardiography. Results: Tetrology of Fallot was present in 142 of 814 new patients seen at the National Institute of Cardiovascul ar Diseases, Karachi between October, 1980 to Octob er, 1981. Forty -five patients, mean age 3.4±2.9 years (Range 0.3—10 years) presented with hypercyanotic spells. Nine patients were older than five years of age (Table 1). Discussion: The management alternatives of patients with Tetrology of Faflot depends upon the individual institution’s surgical expertise89. There are a few Centres in the World where surgical correction of infants with TOF can be safely undertaken under 1 year of age’°”. At our Institute complete repair of Tetro1og of Fallot can be taken at 3-4 years of age. For the smaller children we have performed Aorto-Pulmo-n ary shunt surgery. However, shunt surgery under 6 months of age carries significant mortality in our experience.