Transcatheter embolization of bronchial collateral arteries prior to intracardiac operation for tetralogy of Fallot.

In a case of tetralogy of Fallot with numerous bronchial collateral arteries (BCA), the collateral arteries were successfully occluded by transcatheter embolization of Gelfoam and use of the Gianturco spring as a preliminary to intracardiac repair. Pulmonary embolism would not result from this procedure in the absence of large direct communications between collateral and pulmonary arteries. The femoral artery and vein were prepared for cannulation before the procedure, so that it would be possible to start assisted perfusion immediately if arterial PO2 fell after transcatheter embolization. The procedure is performed under fluoroscopic control.