Abstract
Tetralogy of Fallot (TOF) is one of the most common congenital cardiac malformations and consists of: (1) ventricular septal defect (VSD), (2) right ventricular outflow tract obstruction (RVOTO), (3) aortic override, and (4) right ventricular hypertrophy (RVH). The initial presentation of the patient with TOF is variable and dependent on the degree of right ventricular outflow tract obstruction. In most children with TOF, elective complete repair is recommended preferably by 3–6 months of age. Single-stage complete repair is performed in most large centers with excellent results. The surgical repair of TOF can be performed via a transatrial or transventricular approach to the VSD and the RVOT. The transatrial repair allows excellent visualization of both the VSD and the obstructive muscle bundles within the RVOT while avoiding an incision on the right ventricle. For patients requiring a transannular patch to relieve pulmonary stenosis, the transatrial approach allows for minimal extension of the incision onto the infundibulum as the ventriculotomy is not used for the VSD closure. By avoiding a ventriculotomy, short and long-term impairment of ventricular function can be minimized.
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Hirsch-Romano, J.C., Ohye, R.G., Si, MS., Bove, E.L. (2016). Transatrial Repair of Tetralogy of Fallot. In: Lacour-Gayet, F., Bove, E., Hraška, V., Morell, V., Spray, T. (eds) Surgery of Conotruncal Anomalies. Springer, Cham. https://doi.org/10.1007/978-3-319-23057-3_6
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