Analysis of Tetralogy of Fallot: from anatomy to surgical strategy

Congenital malformations (CMs) are structural, metabolic, or functional anomalies that arise during the embryonic phase, potentially manifesting at birth or throughout life. These malformations are classified as acyanotic or cyanotic, with Tetralogy of Fallot (TOF) being one of the most significant within the cyanotic category, with a prevalence of 4 to 5 cases per 10,000 live births. TOF, when surgically treated, shows good survival rates, making a detailed analysis of its cardiac anatomy and the surgical approaches used in its treatment essential. This study aims to provide a comprehensive overview of TOF, considering its anatomical variations and their impact on the success of surgical interventions. For this purpose, an integrative literature review was conducted, analyzing anatomical variations and the effectiveness of different surgical approaches. The results indicated that anatomical variations in TOF are common and significantly impact surgical treatment, with pulmonary valve reconstruction standing out as an approach that can improve long-term outcomes, despite the incidence of regurgitation during follow-up. Patient age was also identified as a crucial factor in determining the surgical intervention, with complete repair being associated with more favorable outcomes compared to staged repair. It is concluded, therefore, that a detailed description of the anatomical variables of TOF and the personalization of surgical strategies are essential to ensure comprehensive and systematic care for patients with this anomaly.