Current Concepts in Treatment of Tetralogy of Fallot

¹ Departments of Surgery, Pediatrics and Radiology, College of Physicians and Surgeons, Columbia University, and the Surgical Service of Presbyterian and Babies Hospitals

Tetralogy of Fallot is not a single or specific anomaly, but has a wide range of anatomic variations and symptoms. Therefore, the treatment of choice must be selective. Specifically, a systemic to pulmonary artery shunt is indicated for severaly symptomatic infants and children under five years of age. Elective total repair is indicated between the ages of eight and twelve years. Postoperative catheterization studies suggest at least 80 per cent of these patients have good to excellent hemodynamic results. The mortality rate for total correction should approach that of uncomplicated ventricular septal defect, providing the timing and treatment are properly chosen, following total evaluation of the patient's clinical status and anatomic abnormalities.