EDUCATION IN HEART
Congenital Heart Disease
Repaired tetralogy of Fallot in the adult: monitoring and management
1 Division of Cardiology, Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA
2 Division of Cardiology, Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA
Correspondence to:
Kier V Huehnergarth, MD, Division of Cardiology, Box 356422, University of Washington, Seattle, WA 98195, USA; kiervh@gmail.com
| The first 150 words of the full text of this article appear below. |
Tetralogy of Fallot (ToF) is the most common cyanotic congenital heart disease (CHD). The history of surgical treatment of ToF is closely linked with the origins of cardiac surgery. Before the era of cardiac surgery, most ToF patients died in childhood; now well over 85% survive to adulthood, resulting in an increased prevalence of ToF in adults.1 Patients with "repaired" ToF pose unique challenges for primary care providers and cardiologists. This review will focus on the history and changing epidemiology of ToF in adults, the pathophysiology of repaired ToF, and emerging data for monitoring and treatment.
EMBRYOLOGY/ANATOMY
The aorta and pulmonary artery form from septation of the distal bulbus cordis and truncus arteriosus and rotate to overlie the ventricles. Faulty rotation and septation with incomplete transfer of the aorta to a position above the left ventricle results in a malalignment ventricular septal defect (VSD) and an aorta that
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