Good afternoon, everyone. Tetralogy of Fallot is a cyanotic congenital heart defect that represents one of the most common and clinically significant congenital heart diseases worldwide. It is due to a developmental abnormality of the infundibular septum, which results in four cardinal anatomical abnormalities: ventricular septal defect (VSD), pulmonary stenosis, right ventricular hypertrophy, and aortic overjet spanning both ventricles. Together, these defects impair the normal flow of oxygenated blood to the body, causing low blood oxygen levels and symptoms such as cyanosis (a bluish discoloration of the skin), especially in newborns.

It accounts for 7% to 10% of all congenital heart defects and affects approximately 1 in every 1,000 to 2,000 live births. Despite improvements in prenatal imaging, prenatal detection remains a challenge due to factors such as fetal position and operator experience. Postnatal diagnosis generally involves clinical suspicion based on cyanosis and heart murmurs, confirmed by imaging techniques such as chest X-ray, electrocardiogram, and especially echocardiography, which remains the gold standard for definitive diagnosis.

Surgical correction remains the cornerstone of treatment and offers excellent results if performed early. Complete repair usually involves closure of the VSD and relief of the obstruction in the right ventricular outflow tract, sometimes using patches or prosthetic valves. In high-risk newborns or those with complex anatomy, initial palliative surgeries, such as the Blalock-Taussig-Thomas shunt, may be performed before definitive correction. Postoperative care and lifelong cardiological follow-up are essential due to potential late complications, such as pulmonary insufficiency or arrhythmias.

Analysis of tetralogy of Fallot is fundamental in the medical field due to its prevalence, severity, and the window of opportunity it offers for curative treatment. Early recognition and intervention can dramatically alter the natural course of the disease, transforming a condition that once had a poor prognosis into one with over 90% survival into adulthood and a good quality of life.

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