Editing Tetralogy of Fallot (section)

=== Palliative surgery ===
Initially surgery involved forming a side to end [[surgical anastomosis|anastomosis]] between the [[subclavian artery]] and the [[pulmonary artery]] -i.e. a systemic to pulmonary arterial shunt.<ref name="Corno_2009">{{Cite book| vauthors = Corno AF, Festa GP |title=Congenital heart defects : decision making for cardiac surgery. Volume 3, CT-scan and MRI |date=2009|publisher=Steinkopff|isbn=9783798517196|location=Darmstadt |oclc=433550801}}</ref>{{rp|57}} This redirected a large portion of the partially oxygenated blood leaving the heart for the body into the lungs, increasing flow through the pulmonary circuit, and relieving symptoms. The first [[Blalock–Thomas–Taussig shunt]] surgery was performed on 15-month-old [[Eileen Saxon]] on November 29, 1944 with the surgery ending in momentary success. Months later Saxon experienced more symptoms, and was operated on again, shortly before her 2nd birthday. She soon after died.<ref name="JHMI">{{cite web|url=http://www.medicalarchives.jhmi.edu/firstor.htm | title = Blalock–Taussig Shunt |work = First Operations | publisher = The Johns Hopkins Medical Institutions |archive-url=https://web.archive.org/web/20071130044447/http://www.medicalarchives.jhmi.edu/firstor.htm|archive-date=2007-11-30|url-status=live|access-date=2007-11-15}}</ref>

The Potts shunt<ref name="pmid15619282">{{cite journal | vauthors = Boshoff D, Budts W, Daenen W, Gewillig M | title = Transcatheter closure of a Potts' shunt with subsequent surgical repair of tetralogy of fallot | journal = Catheterization and Cardiovascular Interventions | volume = 64 | issue = 1 | pages = 121–123 | date = January 2005 | pmid = 15619282 | doi = 10.1002/ccd.20247 | s2cid = 46528126 }}</ref> and the Waterston–Cooley shunt<ref name="pmid15854971">{{cite journal | vauthors = Daehnert I, Wiener M, Kostelka M | title = Covered stent treatment of right pulmonary artery stenosis and Waterston shunt | journal = The Annals of Thoracic Surgery | volume = 79 | issue = 5 | pages = 1754–1755 | date = May 2005 | pmid = 15854971 | doi = 10.1016/j.athoracsur.2003.11.059 }}</ref><ref name="urlSystemic to Pulmonary Artery Shunting for Palliation: - eMedicine">{{cite web|url=http://emedicine.medscape.com/article/905950-overview|title=Systemic to Pulmonary Artery Shunting for Palliation|website=eMedicine.com|access-date=2009-01-02|url-status=live|archive-url=https://web.archive.org/web/20081229101446/http://emedicine.medscape.com/article/905950-overview|archive-date=2008-12-29}}</ref> are other shunt procedures which were developed for the same purpose. These are no longer used.

Currently, palliative surgery is not normally performed on infants with TOF except for extreme cases.<ref name="Abdulla_2011" />{{rp|173}} For example, in symptomatic infants, a two-stage repair (initial systemic to arterial shunt placement followed by total surgical repair) may be done.<ref>{{Cite book|title=Critical care of children with heart disease : basic medical and surgical concepts|date=2010|publisher=Springer-Verlag| vauthors = Munoz RA |isbn=9781848822627|location=London|page=217|oclc=663096154}}</ref> Potential complications include inadequate pulmonary blood flow, pulmonary artery distortion, inadequate growth of the pulmonary arteries, and acquired pulmonary atresia.<ref name="Corno_2009" />{{rp|59}}