Tetralogy of Fallot

  • Anita SadeghpourEmail author
  • Azin Alizadehasl
  • Mohammad Mahdavi


Tetralogy of Fallot (TOF) as the most common cyanotic congenital heart disease (CHD) is a complex heart defect consisting of four components:


Tetralogy of Fallot (TOF) Cyanotic congenital heart disease (CHD) Right ventricular outflow tract (RVOT) obstruction Absent pulmonary valve syndrome Overriding of aortic root 

Supplementary material

Video 28.1

Transthoracic echocardiography in parasternal long axis view showing Overriding aorta on the crest of the ventricular septum and associated VSD (MPG 1,366 kb)

310404_1_En_28_MOESM2_ESM.mpg (882 kb)
Video 28.2 Typical parasternal short axis view in TOF patient showing anterocephal deviation of outlet septum with narrow RVOT and large sub aortic VSD (MPG 882 kb)
310404_1_En_28_MOESM3_ESM.mpg (914 kb)
Video 28.3 Color flow imaging of the same patient showing large nonrestrictive VSD with bidirectional shun (MPG 914 kb)
Video 28.4

Injection via venous catheter in severely hypertrophied RV showing coincident opacification of aorta and pulmonary artery (due to VSD) and overrided aorta. Also there is infindibular, valvular and supra valvular PS (WMV 916 kb)

310404_1_En_28_MOESM5_ESM.avi (2.7 mb)
Video 28.5 Typical patient with history of repaired TOF now presenting with severe pulmonary regurgitation associated with aneurysmal RVOT and severe RV enlargement (AVI 2,771 kb)


  1. 1.
    Bonow RO, Mann DL, Zipes DP, Libby P. Braunwald’s heart disease: a textbook of cardiovascular medicine. 9th ed. Philadelphia: Elsevier/Saunders; 2011. p. 1435–50.Google Scholar
  2. 2.
    Warnes C, Williams RG, Bashore TM, et al. ACC/AHA, guidelines for the management of adults with congenital heart disease. JACC. 2008;52(23):2008.CrossRefGoogle Scholar
  3. 3.
    Rauch R, Hofbeck M, Zweier C, et al. Comprehensive genotype-phenotype analysis in 230 patients with tetralogy of Fallot. J Med Genet. 2010;47(5):321–31.PubMedCrossRefGoogle Scholar
  4. 4.
    Sadeghpour A, Saadatifar H, Kiavar M, et al. Doppler echocardiographic assessment of pulmonary prostheses: a comprehensive assessment including velocity time integral ratio & prosthesis effective orifice area. Congenit Heart Dis. 2008;3:415–21.PubMedCrossRefGoogle Scholar
  5. 5.
    Al Habib HF, Jacobs JP, Mavroudis C, et al. Contemporary patterns of management of tetralogy of Fallot: data from the Society of Thoracic Surgeons Database. Ann Thorac Surg. 2010;90(3):813–9; discussion 819–20.PubMedCrossRefGoogle Scholar
  6. 6.
    Park CS, Lee JR, Lim HG, et al. The long-term result of total repair for tetralogy of Fallot. Eur J Cardiothorac Surg. 2010;38(3):311–7.PubMedCrossRefGoogle Scholar
  7. 7.
    Fox D, Devendra GP, Hart SA, et al. When ‘blue babies’ grow up: What you need to know about tetralogy of Fallot. Cleve Clin J Med. 2010;77(11):821–8.PubMedCrossRefGoogle Scholar
  8. 8.
    Tsang FH, Li X, Cheung YF, et al. Pulmonary valve replacement after surgical repair of tetralogy of Fallot. Hong Kong Med J. 2010;16(1):26–30.PubMedGoogle Scholar
  9. 9.
    Kyavar M, Sadeghpour A, Madadi S, et al. Echocardiographic assessment of adults with repaired tetralogy of Fallot: a cardiovascular magnetic resonance comparison study. IHJ. 2012;12:2.Google Scholar
  10. 10.
    Sadeghpour A, Kyavar M, Javani B, et al. Term results of mechanical pulmonary prostheses in adults with congenital heart disease: importance of anticoagulation. Circulation. 2012;125(19), oral presentations WCC 2012.Google Scholar
  11. 11.
    Naderi N, Haghighi ZO, Pezeshki S, Alizadehasl A. Quantitative assessment of right atrial function by strain imaging in adult patients with totally corrected tetralogy of Fallot. Arch Cardiovas Imaging. 2013;1(1):8–12.Google Scholar
  12. 12.
    Sadeghpour A, Javani B, Peighambari M, et al. Mid-term follow-up of pulmonary valve bioprostheses in adults with congenital heart disease. Anadolu Kardiyol Derg. 2012;12:434–6.PubMedGoogle Scholar
  13. 13.
    Sadeghpour A, Kyavar M, Madadi S, et al. Doppler-derived strain and strain rate imaging assessment of right ventricular systolic function in adults late after tetralogy of Fallot repair: an observational study. Anadolu Kardiyol Derg. 2013;13:536–42.PubMedGoogle Scholar
  14. 14.
    Oosterhof T, van Straten A, Vliegen HW, et al. Preoperative thresholds for pulmonary valve replacement in patients with corrected tetralogy of Fallot using cardiovascular magnetic resonance. Circulation. 2007;116:545.PubMedCrossRefGoogle Scholar
  15. 15.
    Boechat MI, Ratib O, Williams PL, et al. Cardiac MR imaging and MR angiography for assessment of complex tetralogy of Fallot and pulmonary atresia. Radiographics. 2005;25(6):1535–46.PubMedCrossRefGoogle Scholar
  16. 16.
    He GW. Current strategy of repair of tetralogy of Fallot in children and adults: emphasis on a new technique to create a monocusp-patch for reconstruction of the right ventricular outflow tract. J Card Surg. 2008;23(6):592–9.PubMedGoogle Scholar
  17. 17.
    Hörer J, Friebe J, Schreiber C, et al. Correction of tetralogy of Fallot and of pulmonary atresia with ventricular septal defect in adults. Ann Thorac Surg. 2005;80(6):2285–91.PubMedCrossRefGoogle Scholar
  18. 18.
    Aboulhosn J, Child JS. Management after childhood repair of tetralogy of fallot. Curr Treat Options Cardiovasc Med. 2006;8(6):474–83.PubMedCrossRefGoogle Scholar
  19. 19.
    Witte KK, Pepper CB, Cowan JC, et al. Implantable cardioverter-defibrillator therapy in adult patients with tetralogy of Fallot. Europace. 2008;10(8):926–30.PubMedCrossRefGoogle Scholar
  20. 20.
    Khairy P, Harris L, Landzberg MJ, et al. Implantable cardioverter-defibrillators in tetralogy of Fallot. Circulation. 2008;117(3):363–70.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag London 2014

Authors and Affiliations

  • Anita Sadeghpour
    • 1
    Email author
  • Azin Alizadehasl
    • 2
  • Mohammad Mahdavi
    • 3
  1. 1.Echocardiography Lab, Department of CardiologyAdult Congenital Heart Disease Clinic, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical ScienceTehranIran
  2. 2.Echocardiography Lab, Department of CardiologyRajaie Cardiovascular Medical and Research Center, Iran University of Medical ScienceTehranIran
  3. 3.Pediatric Ward, Department of Pediatric CardiologyRajaie Cardiovascular Medical and Research Center, Iran University of Medical ScienceTehranIran

Personalised recommendations