Anaesthetic management of a dog with tetralogy of Fallot undergoing placement of a modified Blalock-Taussig shunt

Abstract

A 6-month-old male Old English Bulldog with tetralogy of Fallot (ToF) required general anaesthesia for surgical palliative treatment of ToF, whereby a shunt was placed between the left subclavian artery and the pulmonary trunk to increase pulmonary circulation (modified Blalock-Taussig shunt). Anaesthesia of a patient with ToF presents an anaesthetic challenge given the four concurrent cardiac defects as well as the surgical manoeuvres involved, requiring an advanced understanding of the underlying pathophysiology and haemodynamics. Besides this, a thorough knowledge of the clinical effects of anaesthetic events and drugs is required. This case report describes the two major anaesthetic events that occurred and the unexplained hyperkalaemia that developed. Furthermore their management is explained and discussed.