Tetralogy of Fallot Repair

Abstract

The classic lesions of tetralogy of Fallot (TOF) include pulmonary stenosis, ventricular septal defect (VSD), overriding aorta, and right ventricular hypertrophy. The hemodynamically significant lesions are the VSD and pulmonary stenosis that results in right ventricular outflow tract (RVOT) obstruction. Originally, a two-stage repair was performed for repair of TOF. First pulmonary blood flow was increased with systemic-to-pulmonary artery shunts (classic and modified Blalock–Taussig shunt, Waterston shunt, or Potts shunt) followed by a complete repair when the child was older. Complications associated with this strategy include pulmonary hypertension and congestive heart failure from the augmented pulmonary blood flow and stenosis of the pulmonary artery at the anastomotic site.