Waterston anastomosis for initial palliation of tetralogy of Fallot

• Published in: The Journal of thoracic and cardiovascular surgery Vol. 82; no. 2; p. 176
• Main Authors: Parenzan, L, Alfieri, O, Vanini, V, Bianchi, T, Villani, M, Tiraboschi, R, Crupi, G, Locatelli, G
• Format: Journal Article
• Language: English
• Published: United States 01-08-1981
• Subjects: Angiocardiography; Cardiac Catheterization; Child; Child, Preschool; Follow-Up Studies; Humans; Infant; Infant, Newborn; Methods; Palliative Care; Tetralogy of Fallot - mortality; Tetralogy of Fallot - surgery
• ISSN: 0022-5223
• DOI: 10.1016/s0022-5223(19)39351-1

Two hundred twenty-seven patients (median age 5.4 months) in whom a Waterston anastomosis was done for initial palliation of tetralogy of Fallot between 1966 and 1979 were studied. Twelve patients died in the hospital (5.3%; 70% confidence limits, 3.8% to 7.3%). Young age, low weight, and poor clinical condition did not appear to be incremental risk factors, whereas a too large or a too small shunt was largely responsible for the hospital mortality and morbidity. Follow-up information was available in all the 215 patients discharged from the hospital. At the last follow-up visit, before any further surgical procedure, 74% of the patients were clinically in good condition. By actuarial methods, 97.7% of hospital survivors were alive and 95.8% were event-free at and beyond 3 years postoperatively. Eighty-six patients have been catheterized in preparation for secondary repair (mean interval between Waterston shunt and catheterization, 2.9 +/- 1.38 years). One patient developed pulmonary vascular disease, four acquired pulmonary atresia, and 14 had a severe kinking of the right pulmonary artery at the site of the anastomosis.