What are the four malformations of Tetralogy of Fallot?

Right ventricular outflow tract obstruction

Stenosis can range from the entrance of the right ventricular infundibulum to the left and right pulmonary artery branches. It can be infundibulum stenosis, aortic valve stenosis, or both.

Pulmonary valve annulus, common pulmonary trunk dysplasia, and asymmetric stenosis of pulmonary branches are common. The severity of stenosis varies widely.

Patients with mild pulmonary artery stenosis can be shunted from left to right without obvious bruising; when pulmonary artery stenosis is severe, there will be obvious right-to-left shunting with obvious bruising.

The murmur is due to a right ventricular outflow tract obstruction rather than a ventricular septal defect.

ventricular septal defect

It is a perimembranous defect that extends to the outflow tract, mostly under the aorta, and can extend under the pulmonary artery. It is a poorly aligned ventricular septal defect.

For non-limiting, left and right ventricular pressures are substantially equal.

Aortic Ride

The aortic root is thick and clockwise rotated to the right and rides over the ventricular septal defect, ranging from 15% to 95%.

In addition to receiving blood from the left ventricle, the aorta also directly receives a part of the venous blood from the right ventricle, which is transported to all parts of the body, resulting in bruising. The blood flow was reduced, and the bruising was even worse.

Right ventricular hypertrophy

As a secondary change, right ventricular outflow tract obstruction increases right ventricular afterload, causing compensatory right ventricular hypertrophy.

Planning: Zhang Jie

Title image: Zhanku Hailuo