Corrected Tetralogy of Fallot for Hernia Repair

You are in the preadmission clinic reviewing a 25-year-old man who has been scheduled for an open repair of a large right inguinal hernia in eight weeks' time. Your hospital has an intensive care unit but there is no facility for cardiac surgery. He was born with Tetralogy of Fallot (TOF) which consisted of: 1. Ventricular septal defect (VSD) 2. Right ventricular (RV) outflow tract obstruction (RVOTO) 3. RV hypertrophy (RVH) 4. An overriding aorta and a hypoplastic left pulmonary artery. At 3 months of age he had a Blalock shunt as a temporary measure (supplying blood to the hypoplastic pulmonary artery) and at 3 years of age his TOF was fully repaired. He takes no regular medications. He works part-time at the local supermarket and sometimes gets short of breath on exertion. Investigations included: ECG Echocardiogram and stress echo reports