A rare case of Tetralogy of Fallot(TOF) with Potts shunt - 4th decade of survival

Potts shunt is one of the palliative shunt done before the corrective surgery era for TOF. It is done by side to side anastomosis between LPA and descending thoracic aorta .Due to long term risk of increased pulmonary vascular resistance with potts shunt, it is not done as a primary modality of surgery nowadays but in olden days it has saved many cyanotic heart disease patients like TOF and tricuspid atresia. The first Blalock-ThomasTaussig shunt surgery was performed on 15-month old Eileen Saxon on November 29, 1944 with dramatic results. The Potts shunt and the Waterston-Cooley shunt are other shunt procedures which were developed for the same purpose. For unoperated patients with TOF of all degrees of severity, 11 percecent are alive at age 20 years, 6 percent at age 30 years, and 3percent at age 40 year. In 1946 Potts demonstrated the efficiency of anastomosing the descending aorta to the left pulmonary artery in relieving cyanotic congenital heart disease, and showed it to be especially valuable in young babies in whom a Blalock shunt is not technically feasible. With potts shunt life is definitely prolonged with improved symtomatology. Here we are going to present one such case of TOF with potts shunt surgery done at the age of 4 years(1983) and surviving up to 32 years of age with minimum discomfort.