The diagnosis and surgical treatment of tetralogies.

Patients with congenital heart disease of the cyanotic type may be presumed to be candidates for surgical treatment if the examination of the heart reveals compatible findings, particularly murmurs characteristic of an interventricular septal defect, overriding aorta, and pulmonary stenosis; if the electrocardiogram shows right axis deviation; if the x-ray or fluoroscopic study demonstrates decreased pulmonary markings; if Diodrast injection shows right ventricular enlargement, a septal defect, overriding of the aorta, and small pulmonary arteries. In some cases some of these criteria may be missing. If there are not definite contraindications, exploratory thoracotomy is indicated for patients with congenital heart disease causing cyanosis.