ABSTRACT
Patients with TOF have symptoms and signs that range from cardiac failure with no cyanosis to severe cyanosis with hypoxemia and acidemia. No treatment was known for this abnormality until a landmark publication by Blalock and Taussig in 1945,6 in which an aortic-to-pulmonary shunt was successfully introduced in three patients with marked relief
Figure 26.1 Pathology of tetralogy of Fallot in a long axial oblique view. (VSD, ventricular septal defect.)
Figure 26.2 Central pathology of tetralogy of Fallot. The outlet septum (OS) is supported by the hinges along its left anterior margin. It is pulled anteriorly into the right ventricular outflow tract in tetralogy, leaving a ventricular septal defect (VSD) of anterior malalignment type. The aortic valve overrides the ventricular septum because it is displaced anteriorly with the outlet septum. The deviated outlet septum encroaches on the subpulmonary outflow tract dimension.
