Tetralogy of Fallot.

Based on our experience and the data presented here the following general approach may be used in the management of patients with tetralogy of Fallot: 1. Symptomatic infants under 6 months of age should be considered for an initial palliative shunt, preferably a Blalock-Taussig shunt or a Gore-tex modification of that procedure. 2. Symptomatic patients older than 6 months of age should be considered candidates for total correction, unless there are anatomic contraindications (anomalous left anterior descending artery, severe hypoplasia of the main pulmonary artery, multiple branch stenoses, multiple ventricular septal defects, or pulmonary atresia), or the predicted PRV/LV is greater than 0.7. 3. Total correction with closure of shunt should be undertaken in all patients prior to 5 years of age.