Abstract
Severe pulmonary hypertension and pulmonary vascular disease developed after unilateral Blalock-Taussig anastomosis (BTA) for tetralogy of Fallot in the case reported. Seven similar cases from the literature are reviewed. In contrast to experience after Potts' anastomosis, development of severe pulmonary hypertension and pulmonary vascular disease after BTA is very rare. Clinical signs include increasing cyanosis, loss of the continuous murmur, and a loud pulmonary-valve closure sound. The chest roentgenogram typically shows dilatation of the central pulmonary arteries. Cardiac catheterization with determination of pulmonary/systemic flow and resistance ratios is essential in evaluating operability. In all reported cases, the anastomosis was made at ages at which complete surgical repair would be offered now. The anastomosis in young children (less than five years old) has not been associated with development of pulmonary vascular disease.
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