"extracardiovascular associations: may be present in ~15% of cases 10"
"rare associations:"
"Contrast enhanced CT is useful in demonstrating the complex cardiovascular morphology of tetralogy of Fallot, especially the anatomy of the pulmonary and coronary arteries as well as identification of major aortopulmonary collateral arteries (MAPCAs). CT can be used to evaluate post-surgical changes (e.g. patency of palliative shunts) and complications."
"Common post-surgical complications include 6,27:"
"Maintaining ductal patency with prostaglandin E1 is essential in duct-dependent TOF until definitive surgical or catheter-based intervention can be performed. However, the PDA may also lead to pulmonary volume overload and heart failure or systemic hypoperfusion, depending on the balance of systemic and pulmonary vascular resistance 26."
"residual ventricular septal defect in 10–20% of cases"
"It is named after Étienne-Louis Arthur Fallot (1850-1911) 19, a French physician, who described the tetralogy of defects in 1888 14."
"anomalous origin of the right coronary artery from the pulmonary artery (ARCAPA) 21"
"dilation of the RVOT may be observed"
"dynamic obstruction of the RVOT may be noted, resulting from incursion of the infundibulum into the outflow tract"
"continuous-wave Doppler through the RVOT may demonstrate a late-peaking, high-velocity envelope, consistent with dynamic obstruction"
"residual or recurrent RVOT obstruction and branch pulmonary artery stenosis"
"aneurysm at the RVOT patch site and rarely, rupture"
"aortic root is overriding but not enlarged; PA trunk is, conversely, very large with to-and-fro flow due to both stenosis and insufficiency; ductus arteriosus is classically absent or atretic"
"Maintaining ductal patency with prostaglandin E1 is essential in duct-dependent TOF until definitive surgical or catheter-based intervention can be performed. However, the PDA may also lead to pulmonary volume overload and heart failure or systemic hypoperfusion, depending on the balance of systemic and pulmonary vascular resistance 26."
"Waterston shunt: side-to-side anastomosis between the ascending aorta and right pulmonary artery; rarely used due to risk of pulmonary artery distortion and pulmonary hypertension"
"Pott shunt: side-to-side anastomosis between the descending aorta and left pulmonary artery; also rarely used for similar reasons"
Expected headings
"Associations"
"Echocardiography"
"The presentation relies on the degree of right ventricular outflow tract obstruction (RVOTO) and right to left shunting. Typically this is significant, causing neonatal cyanosis. In cases where outflow obstruction is minimal, cyanosis may not be apparent (pink tetralogy); around 10% may be diagnosed in adulthood, depending on severity and healthcare resources 28."
"Waterston shunt: side-to-side anastomosis between the ascending aorta and right pulmonary artery; rarely used due to risk of pulmonary artery distortion and pulmonary hypertension"
"Pott shunt: side-to-side anastomosis between the descending aorta and left pulmonary artery; also rarely used for similar reasons"
"pulmonary atresia with ventricular septal defect: considered an extreme form of tetralogy of Fallot, the pulmonary atresia is obstructed with anterograde flow; the ductus arteriosus is tortuous with retrograde flow in the pulmonary arteries; surgery and prognosis is related to the anatomy of the pulmonary arteries"
"pulmonary atresia with ventricular septal defect: considered an extreme form of tetralogy of Fallot, the pulmonary atresia is obstructed with anterograde flow; the ductus arteriosus is tortuous with retrograde flow in the pulmonary arteries; surgery and prognosis is related to the anatomy of the pulmonary arteries"
"aortic root is overriding but not enlarged; PA trunk is, conversely, very large with to-and-fro flow due to both stenosis and insufficiency; ductus arteriosus is classically absent or atretic"
"aortic root is overriding but not enlarged; PA trunk is, conversely, very large with to-and-fro flow due to both stenosis and insufficiency; ductus arteriosus is classically absent or atretic"
"Non-syndromic TOF is linked to rare variants in genes such as NKX2-5, GATA4, HAND2, NOTCH1, FLT4 and TBX1."