Correction of tetralogy of fallot with combination of operative and interventional methods.

A one-stage repair was planned for an 11-year-old boy with tetralogy of Fallot. After initial attempts to wean from cardiopulmonary bypass were unsuccessful, an atrial septal defect and a ventricular septal defect were created in order to achieve hemodynamic stability. The boy recovered from the operation but had large volume of chest drainage. Transthoracic echocardiography revealed left to right shunting at both atrial and ventricular levels. Interventional catheter-directed devices were used to repair the residual shunts successfully in the catheterization laboratory.