Babies with Tetrology of Fallout have two treatment options - the first is palliative where no open heart surgery is done and the defect is treated with shunt operation. The second is complete repair - which is definitive treatment where the patient undergoes an open heart surgery with a heart lung machine. In the case of Baby Brendan we obviously chose the second option due to its curative value. But the problem we faced was that the heart lung machine requires 500 ml of blood by itself to drive away the air and still haemoglobin at acceptable level. The challenge was with the baby weighed only 11 kgs and his blood volume was 800 - 900 ml and to conduct an open heart proved difficult without additional usage of blood" said Dr. Devananda.