Anesthetic management for a palliative surgical procedure in a 72-year-old patient with tetralogy of Fallot

Abstract

T ETRALOGY OF Fallot (TOF) is the most common form of congenital heart disease producing a right-toleft intracardiac shunt and arterial hypoxemia. The malformation consists of: (1) pulmonary artery outflow obstruction; (2) a large ventricular septal defect; (3) dextroposition of the aorta (biventricular origin or the aorta); and (4) right ventricular hypertrophy. Intracardiac repair of TOF is usually undertaken during infancy or childhood. However, some patients can reach adulthood without total correction or palliation. Indeed, case reports of patients surviving to the seventh decade of life have been reported. The oldest recorded patient with TOF was 69 years old,’ the oldest patient to have a total correction of TOF was 67 years old,2 and the oldest to undergo a systemic-pulmonary shunt for palliative operation for congenital heart disease was 22 years old.” The anesthetic management of a 72-year-old woman undergoing a modified right Blalock-Taussig shunt for palliation of TOF is reported.