A rare case of Tetralogy of Fallot(TOF) with Potts shunt - 4th decade of survival

Abstract

Potts shunt is one of the palliative shunt
done before the corrective surgery era
for TOF. It is done by side to side anastomosis
between LPA and descending
thoracic aorta .Due to long term risk of
increased pulmonary vascular resistance
with potts shunt, it is not done as a primary
modality of surgery nowadays but
in olden days it has saved many cyanotic
heart disease patients like TOF and tricuspid
atresia. The first Blalock-Thomas-
Taussig shunt surgery was performed on
15-month old Eileen Saxon on November
29, 1944 with dramatic results. The Potts
shunt and the Waterston-Cooley shunt
are other shunt procedures which were
developed for the same purpose. For unoperated
patients with TOF of all degrees
of severity, 11 percecent are alive
at age 20 years, 6 percent at age 30
years, and 3percent at age 40 year. In
1946 Potts demonstrated the efficiency
of anastomosing the descending aorta to
the left pulmonary artery in relieving cyanotic
congenital heart disease,
and showed it to be especially valuable in
young babies in whom a Blalock shunt is
not technically feasible. With potts shunt
life is definitely prolonged with improved
symtomatology. Here we are going to present
one such case of TOF with potts shunt
surgery done at the age of 4 years(1983)
and surviving up to 32 years of age with
minimum discomfort.