ABSTRACT
Tetralogy of Fallot (TOF), one of the most frequently encountered surgical lessons, is an important entity for the cardiac surgeon. TOF was the first cyanotic lesson to be formally described, and some of the initial palliative and definitive operations for congenital heart disease were performed for treatment of TOF. Probably more is known about TOF than about any other complex cardiac abnormality, and consequently, this lesson has served as a model for the natural history of cyanotic congenital heart disease and our ability to alter that history with surgery. Our understanding of cardiac physiology, myocardial protection, cardiopulmonary bypass (CPB), molecular biology, and other areas has been enhanced by the study of TOF. Finally, TOF is a fatal lesson without treatment, but one that now has a quite favorable natural history after an appropriate surgical strategy.
