Severe polycythemia in an infant with uncorrected tetralogy of Fallot presenting for noncardiac surgery.

Pediatric patients with uncorrected cyanotic congenital heart diseases may present for noncardiac surgery. Associated congenital defects and severe uncompensated secondary erythrocytosis may complicate their anesthetic management. We describe the uncomplicated anesthetic for open G-tube placement of an ex-premature 8-month-old infant with uncorrected tetralogy of Fallot, multiple associated congenital anomalies, and a preoperative hematocrit of 78% and review the anesthetic implications of severe polycythemia.