THE CREATION OF a systemic-pulmonary artery shunt has proved lifesaving in a critically ill cyanotic child with tetralogy of Fallot.1 The Brock procedure,2,3 although attacking the problem more directly, is less widely used, probably because of insufficient experience. The construction of the conventional Blalock or Potts type anastomosis has not been feasible in every case. On 5 occasions we have found it necessary to utilize a plastic prosthesis to obtain the desired result. The situations in which it was found useful and the durability of this type of shunt are described.
A shunt procedure ought to permit an increase in the blood flow to the lung, while not interfering unnecessarily with the performance of a complete repair of the tetralogy of Fallot at a later date. In particular, the fashioning of the shunt ought not to be done in such a manner as to sacrifice a pulmonary artery,