Tetralogy of Fallot. Systematic review for a Comprehensive Approach

Abstract

Tetralogy of Fallot is a complex cyanotic congenital heart disease, with a considerable prevalence worldwide, which requires preferently intervention during the first year, and whose clinical characteristics will vary according to the degree of pulmonary obstruction and the age of onset. Clinical evaluation must arrange from anamnesis with a prenatal and postnatal history, comprehensive physical examination to imaging evaluation. Diagnosis is mul-tivariate. Knowledge of hypoxemic crises is essential for its management in severe cases. Therefore, surgical management is the only adequate management for this entity, unless patient has a hypoxic crisis where volume replacement is the fundamental for its manage-ment. Although at the present, the most performed surgical management is the placement of a transannular patch with enlargement/release of the outflow tract, when the obstruction is severe in the neonatal stage, stent placement has been successfully performed at the level of the outflow tract that even exceeds the pulmonary valve in order to ensure effective pulmonary flow. Prognosis and long-term sequelae will depend on timely diagnosis, opti-mal medical and surgical management and pathophysiological understanding.