Tips and pearls for "true" dextroposition of the aorta in tetralogy of Fallot

Infundibular stenosis may develop secondary to ventricular septal defect, and transannular patch plasty can affect mortality and morbidity rates. Therefore, dextroposition of the aorta has been investigated in order to eliminate discrepancies in the literature. Figures and illustrations from the selected references have been investigated and "actual dextroposition of the aorta" has been evaluated as far as the aorta is visible. A careful examination of these figures revealed the following tips and pearls for accurate diagnosis of dextroposition of the aorta: Aorta and ventricular septal defect should be adjacent for a "true" dextroposition of the aorta; the plane where the aorta exits from the ventricle should penetrate the plane of the ventricular septal defect towards the right ventricle; if the aorta and ventricular septal defect intersect at one edge, the aorta may seem to be dextroposed; new diagnostic modalities are necessary to evaluate the actual dextroposition status of the aorta for the proper planning of treatment.