Current Considerations in the Surgical Management of Tetralogy of Fallot

¹ Associate Professor and Director, Division of Cardio-Thoracic Surgery

Tetralogy of Fallot has been treated by aortic-pulmonary anastomosis, and by total correction utilizing deep hypothermia. Total open heart correction is currently performed utilizing total cardiopulmonary bypass. More recently there has been a trend toward early total open heart correction in small infants and neonates utilizing deep hypothermia and circulatory arrest, and away from the palliative anastomotic operations in these infants. The critical role of the degree of anatomic abnormality of the right ventricular outflow tract, the place and optimal age for complicated outflow tract reconstruction, and the relative merits of the single stage early correction versus the two-stage procedure (early systemic-pulmonary anastomosis and later total correction) are reviewed in the light of current experience.