End stage treatment of TOF is -

Ans. is 'b' i.e., Modified BT shunt o Tetralogy of fallot: BT shuntfsystemic-pulmonary artery (PA) shunts:Classic BT shunt: The subclavian artery' is anastomosed to the ipsilateralpulmonary artery (PA). This procedure is usually performed in infants older than 3- months; a right-sided shunt is performed in patients with left aortic arch; a left sided shunt is performed for right aortic arch.Modified Blalock-Taussig shunt: A Gore-Tex interposition graft is placed between the subclavian artery' and the ipsilateral PA. This is the most popular procedure for any age, especially for small infants younger than 3 months of age. A left-sided shunt is preferred for patients with a right aortic arch. The surgical mortality rate is 1% or less.The Waterston shunt: Anastomosis is performed between the ascending aorta and the right PA; this shunt is no longer performed because of high incidence of surgical complications, which include too latge a shunt leading to congestive heart failure (CHF) or pulmonary hypertension, or both, and narrowing and kinking of the right PA causing difficulty at the time of corrective surgery:The Pott-shunt operation: Anastomosis is performed between the descending aorta and the left PA; this shunt is no longer performed. It may result in CHF or pulmonary* hypertension, as in the Waterston operation. Moreover, left thoracotomy is required to close the shunt during corrective surgery: