Paradoxical results of infundibular resection in tetralogy of Fallot

The ultimate aim of surgical treatment of Fallot's tetralogy is complete anatomic repair by removal of the obstruction to pulmonary blood flow and closure of the ventricular septal defect. This ideal has been achieved by a small number of surgeons using a pump oxygenator and cardiac arrest. Until it can be realized by all, less complete operations will be performed that will improve the condition without correcting it. Considerable clinical improvement follows infundibular resection by open cardiotomy with or without pulmonary valvotomy. Paradoxically some of these patients may develop a syndrome of heart failure due to the development of a left-to-right shunt through the ventricular septal defect.