Early medical and surgical intervention for tetralogy of Fallot with absence of pulmonic valve

Tetralogy of Fallot with absent pulmonic valve is a rare but life-threatening syndrome. Children with this complex may have aneurysmally dilated pulmonary arteries which compress the tracheobronchial tree and cause airway compromise and death. This paper reviews the course of 10 children with this syndrome who were seen at our institution from 1962 until the present. Two infants with respiratory distress secondary to tetralogy plus absent pulmonary valve were treated with early aggressive medical intervention followed by operation. After closure of the ventricular septal defect and reconstruction of the right ventricular outflow tract, the pulmonary artery aneurysms were resected. Both children are growing and are well more than 1 year after the operations. Our experience with these two patients suggests that such infants may benefit from this form of therapy.