TETRALOGY OF FALLOT

• Most common form of cyanotic heart disease; 6-10% of all congenital heart disease.
• Constellation of- Large Ventricle Septal Defect, Right Ventricle Outlet Track obstruction (pulmonic stenosis), Aorta override, Right Ventricle Hypertrophy.
• Degree of cyanosis dependent on degree of Right Ventricle Outlet Track obstruction.
• Significant RVOT obstruction presents early with cyanosis.
• Mild RVOT obstruction presents later without cyanosis (pink TET) with murmur.
• CXR- Boot shaped heart due to RVH.
• Severe TET with Pulmonary Atresia.
• Severe stenosis requires PGE to maintain pulmonary blood flow.
• Initial palliation with systemic to pulmonary shunt in infant with small Pulmonary atresia/stenosis (early BT Shunt).
• Primary repair in infant with well-formed pulmonary arteries (3-5 months)
• Asymptomatic (pink) repaired later during the first year.

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