The Journal of Thoracic and Cardiovascular Surgery, Vol 82, 176-181, Copyright © 1981 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Waterston anastomosis for initial palliation of tetralogy of Fallot
L Parenzan, O Alfieri, V Vanini, T Bianchi, M Villani, R Tiraboschi, G Crupi and G Locatelli
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.
