Correction of tetralogy of Fallot after Waterston shunt

The authors have reviewed their experience concerning twenty-seven patients who underwent intracardiac repair of Fallot's Tetralogy after a previous Waterston shunt. They are divided into 4 groups according to the classification of Shinebourne, Anderson and Bowyer. The risk factors are analyzed in group 1 patients in whom primary total correction is contra-indicated and in whom the mortality at repair is high in presence of kinking of right pulmonary artery. The type of surgery is still debatable. For the symptomatic patients of the other groups, primary total correction at any age seems, at this time, to be the treatment of choice. The contra-indications are an anterior descending coronary artery arising from the right coronary artery or associated complex anomalies which would make total correction difficult.