Tetralogy of Fallot: the oldest reported survivor of Brock's procedure

Revival of Brock's Operation for Intermediary Palliation of Fallot's Tetralogy in Children Anatomically Unsuitable for One-Stage Total Correction of the Anomaly: Interim Results of Two Cases

One-stage total correction is known to be anatomically unsuitable for correcting tetralogy of fallot (TOF) in a certain proportion of children. Surgeons are thus faced with dilemmas regarding which preliminary operation for the anomaly to do first. Brock's primary postulation suggests that pulmonary trunk and annulus enlargement leading to the correction of the outflow obstruction will favor the subsequent total correction. In line with this, the current article presents two patients who were 6 months and 5 years old. The first patient underwent primary Brock's operation while the second patient had a blocked modified Blalock-Taussig's shunt (MBTS) done off-pump. Following the discontinuation of anti-platelet medications, the MBTS blocked and the patient was subsequently considered for secondary Brock's operation. The outcome of both procedures involved the patients' discharge with uneventful hospital stays and regular follow-ups at specified intervals. Thus, Brock's operation is an excellent preliminary palliative procedure for one-stage total correction of TOF. There is a need to revive 'Brock's procedure' for patients with TOF and poor pulmonary artery anatomy as the procedure of choice. The first direct intra-cardiac operation aimed at directly addressing the pathological anatomy on its Diamond Jubilee Year.

The Longest Documented Postoperative Survivor of a Brock Procedure 63 Years Later

An infant with critical pulmonary valve stenosis underwent a Brock procedure in 1957 with subsequent repair of pulmonary stenosis and an atrial septal defect (ASD) at age 6. At age 17, she developed paradoxical embolization secondary to a residual ASD, which was repaired. Fifty-four years later, she presented with recurrent pulmonary stenosis and a symptomatic 6.2-cm pulmonary artery aneurysm repaired with a 23-mm aortic homograft. This patient is the longest reported postoperative survivor following a Brock procedure. She continues to do well 63 years after her initial surgery.