The surgical treatment of Fallot's tetralogy.

We regard F a l l o t ' s tetralogy as being a condition of cyanotic congenital heart disease associated with pulmonary stenosis and a ventricular septal defect. The overriding of the aorta does not, in our opinion, constitute a surgical problem. We look upon it in the same light as the associated right ventricular hypertrophy, namely a secondary effect of the altered haemodynamics and not a primary anomaly. We have no doubt t ha t the ideal t reatment for F a l l o t ' s tetralogy is resection of the pulmony stenosis and closure of the ventricular septal defect — in other words a one stage total corrective procedure. We do not consider the B l a l o c k method of bypassing the obstruction as acceptable or desirable and have not used the B l a l o c k operation as a routine form of t reatment of the condition since about 1953.