McNicholas K W, Malm J R
Cardiovasc Clin. 1981;11(2):323-36.
Based on our experience and the data presented here the following general approach may be used in the management of patients with tetralogy of Fallot: 1. Symptomatic infants under 6 months of age should be considered for an initial palliative shunt, preferably a Blalock-Taussig shunt or a Gore-tex modification of that procedure. 2. Symptomatic patients older than 6 months of age should be considered candidates for total correction, unless there are anatomic contraindications (anomalous left anterior descending artery, severe hypoplasia of the main pulmonary artery, multiple branch stenoses, multiple ventricular septal defects, or pulmonary atresia), or the predicted PRV/LV is greater than 0.7. 3. Total correction with closure of shunt should be undertaken in all patients prior to 5 years of age.
根据我们的经验及此处呈现的数据，法洛四联症患者的管理可采用以下一般方法：1. 6个月以下有症状的婴儿应考虑先行姑息性分流术，最好是布-塔分流术或该手术的戈尔特斯改良术。2. 6个月以上有症状的患者应考虑行根治手术，除非存在解剖学禁忌证（左前降支动脉异常、主肺动脉严重发育不全、多处分支狭窄、多处室间隔缺损或肺动脉闭锁），或预计的肺血管阻力/左心室比值大于0.7。3. 所有患者均应在5岁之前进行根治性手术并闭合分流。
