[Surgical anatomy of tetralogy of Fallot]

We analyzed 131 hearts with tetralogy of Fallot for their prominent surgical anatomical features. Special attention was paid to the different elements of the right ventricular outflow tract obstruction, the supraventricular bands and types of septal defect and their relations with the conducting tissue and coronary supply. The infundibular region proved to be the core of the malformation in tetralogy, the left and anterior septal deviation being the origin of pulmonary stenosis and the rest of the embryopathological elements that characterize this malformation. Our results support the notion that each case has, besides the general features of the malformation, particular aspects which must be analyzed. This conjunction of general and particular features provides the clinician with a morphological basis for the interpretation of the diverse diagnostic procedures and the surgeon with the general scope of tetralogy and the individual features of each case which must be taken into account in the choice of the best possible surgical procedure.