I was very interested to read the report in your esteemed paper “Goan infant undergoes life-saving procedure at KLES” and wish to share in the joy of doctors and ailing baby. Tetralogy of Fallot (ToF) with pulmonary atresia (ToF-PA) is a complex congenital heart defect at the extreme end of the spectrum of ToF, with no antegrade flow into the pulmonary arteries. Patients differ with regard to the sources of pulmonary blood flow. I have a few questions that I would like to ask and more can be asked according to their replies. It is OK that they did not go for a B-T shunt but how much and how long do they plan to sit tight basking in the glory of a stented PDA in a grossly aberrant pulmonary circulation? When would they go for a more holistic surgery with a decent unifocalization of the grossly aberrant vessels? Would you think of a Glenn? Was she a syndromic baby? Is there a paediatric surgeon at your institution with a solid experience of correcting such anomalies with maximum experience in this field. Unfortunately I have no more data at hand and so am only half impressed for now.
