Brock Procedure for the Relief of Pulmonary Stenosis in the Tetralogy of Fallot

Downing, Daniel F.; Bailey, Charles P.; Glover, Robert P.

doi:10.1542/peds.7.2.230

Cited by 21 publications

(4 citation statements)

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“…Seven of the eight patients survived with improvement in cyanosis and exercise tolerance. Both Brock and Downing found that there was a higher than initially believed incidence of pulmonary valvular stenosis in TOF patients [25].…”

Section: Surgical Treatment—early Yearsmentioning

confidence: 99%

Tetralogy of Fallot: Yesterday and Today

Starr

2009

World j. surg.

128

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Tetralogy of Fallot (TOF) is a cyanotic congenital cardiac defect that was first described by Stenson in 1672 and later named for Fallot, who in 1888 described it as a single pathological process responsible for (1) pulmonary outflow tract obstruction, (2) ventricular septal defect (VSD), (3) overriding aortic root, and (4) right ventricular hypertrophy. The surgical history of TOF began with the development of the systemic to pulmonary artery shunt (BT shunt) by Blalock, Taussig, and Thomas in 1944. Ten years later complete repair of TOF was performed by Lillehei using cross-circulation and by Kirklin with a primitive cardiopulmonary bypass circuit. Notable contributions by several other surgeons including Bahnson, Ebert, Malm, Trusler, Barratt-Boyes, and Castaneda would lead us into the modern era of surgery. Today, complete repair of TOF is performed before six months of age with low mortality (<2%). In select cases a modified version of the BT shunt is still performed as the initial procedure. Long-term survival rates are excellent (85%-90%). Adult survivors with TOF are an ever-increasing population and may require reintervention, surgically or catheter based. Promising future innovations include percutaneous pulmonary valve replacement, tissue-engineered autologous valves and conduits, and genetic manipulation. This article presents a review of TOF, including the history of surgical treatment, present-day approaches, and long-term outcomes.

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Section: Surgical Treatment—early Yearsmentioning

confidence: 99%

Tetralogy of Fallot: Yesterday and Today

Starr

2009

World j. surg.

128

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“…in 1948, Brock described a method that relieved pulmonary truncus stenosis in cases of pulmonary valve stenosis or conus arteriosus. the procedure consisted of dilating the valve stenosis by valvulotomy using a cutting knife [15]. in 1952, lewis and taufic performed the first intracardiac procedure to close an atrial septal defect (Asd).…”

Section: Discussionmentioning

confidence: 99%

Patient with tetralogy of Fallot at 30-year follow-up – a historical overview of the treatment of the defect

Gruszczyńska,

Kowalik,

Modrzejewski

2024

fmpcr

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A -study design, B -data collection, C -statistical Analysis, D -data interpretation, E -Manuscript Preparation, F -literature search, G -funds collection the authors present the case of a patient with tetralogy of fallot. the patient underwent surgery to correct the defect 30 years ago. our patient remains in good condition, currently reporting only poorer exercise tolerance. the authors attempted to analyse the development of treatment methods for tetralogy of fallot based on world literature with reference to the case described in this paper. this paper presents the history and advances that have been made in the treatment of fallot syndrome. numerous details and dates are cited regarding the history of the treatment of the defect. due to the vastness of the subject of tetralogy of fallot, the article does not discuss contemporary treatments for the defect.

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“…Closed pulmonary valvotomy was another procedure separately elucidated by Sellors in the same year [ 4 ]. The first three cases described by Brock were three children who had TOF and their procedures were undertaken via the LPA, with poor outcomes [ 5 ].The Brock’s technique was subsequently refined by reaching the pulmonary valve via a closed right ventriculotomy. However, because the background infundibular stenosis was not addressed, Brock created a punch method to resect the stenosed infundibulum, leading to better outcomes among five children [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

“…The first three cases described by Brock were three children who had TOF and their procedures were undertaken via the LPA, with poor outcomes [ 5 ].The Brock’s technique was subsequently refined by reaching the pulmonary valve via a closed right ventriculotomy. However, because the background infundibular stenosis was not addressed, Brock created a punch method to resect the stenosed infundibulum, leading to better outcomes among five children [ 5 ]. In 1955, he published a case study involving 150 children having TOF where the punch approach was carried out whether combined or not with pulmonary valvotomy [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

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

Bhende¹,

Sharma²,

Subramaniam³

et al. 2023

Cureus

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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.

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Brock Procedure for the Relief of Pulmonary Stenosis in the Tetralogy of Fallot

Cited by 21 publications

References 0 publications

Tetralogy of Fallot: Yesterday and Today

Tetralogy of Fallot: Yesterday and Today

Patient with tetralogy of Fallot at 30-year follow-up – a historical overview of the treatment of the defect

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

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