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A 65-year-old man with Tetralogy of Fallot having respiratory dysfunction is reported. He had a history of pulmonary tuberculosis and experienced right upper lobectomy and thoracoplasty, he had severe hypoxemia (PaO2 35.0 mmHg, Sat, 68.5% under room air) and low quality of life. Total corrective surgery (patch closure for ventricular septal defect, patch enlargement for right ventricular outflow tract, pulmonary valve replacement with bioprosthesis) was performed. Pulmonary edema which was similar to adult respiratory distress syndrome occurred on the first postoperative day after temporary weaning from respirator although circulatory correction was successful. Management with respirator was continued until the 7th postoperative day. It seemed that high pulmonary blood flow and pulmonary hypertension after operation resulted in increase of capillary permeability of lung. One month later there was no gait disturbance and no dyspnea (PaO2 59.8 mmHg, Sat. 92.3% under room air). This patient was the oldest one with Tetralogy of Fallot undergoing successful corrective surgery.
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