Skip to main content
NCBI home page
The Texas Heart Institute Journal logoLink to The Texas Heart Institute Journal
. 1994;21(4):272–279.

Tetralogy of Fallot. The first 300 years.

C A Neill 1, E B Clark 1
PMCID: PMC325189  PMID: 7888802

Abstract

The chronicle of tetralogy of Fallot is part of a dramatic evolution in cardiology, cardiac surgery, and understanding of the developing heart. Many new tools and concepts have evolved since Steno of Denmark first described the defect in 1673, and since Fallot of Marseilles coined the term tetralogy in 1888. Four major eras of progress can be recognized. The 1st, the era of pathologic anatomy, culminated in the publication of Maude Abbott's Atlas of Congenital Cardiac Disease in 1936. The next, the era of clinicophysiology and surgery, was highlighted by the 1st Blalock-Taussig anastomosis in 1944, by open-heart surgery 10 years later, and by a new team approach to cardiology. The 3rd, or infant era, began in the mid 1970s with successful intracardiac repair in infants, the rise of echocardiography, and the introduction of prostaglandin therapy. The current era of cardiac development (beginning in the 1990s) gives hope for early understanding of the molecular basis of tetralogy. Tribute is due to the surgical and medical pioneers, and to the pioneer patients and their families, for revolutionary changes in diagnosis and treatment. The challenge of the next 100 years lies in increased understanding of the molecular biology of the defect and in preserving the blend of humanism, scholarship, and skill that have graced the advances of the past 3 centuries.

Full text

PDF
272

Images in this article

273Image
on p.273
275Image
on p.275

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Allan L. D., Tynan M. J., Campbell S., Wilkinson J. L., Anderson R. H. Echocardiographic and anatomical correlates in the fetus. Br Heart J. 1980 Oct;44(4):444–451. doi: 10.1136/hrt.44.4.444. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. BROCK R. C. Pulmonary valvulotomy for the relief of congenital pulmonary stenosis; report of three cases. Br Med J. 1948 Jun 12;1(4562):1121–1126. doi: 10.1136/bmj.1.4562.1121. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Bahnson H. T. Classics in thoracic surgery: surgical treatment of pulmonary stenosis: a retrospection (Alfred Blalock). Ann Thorac Surg. 1982 Jan;33(1):96–98. doi: 10.1016/s0003-4975(10)63209-2. [DOI] [PubMed] [Google Scholar]
  4. Barratt-Boyes B. G., Neutze J. M. Primary repair of tetralogy of Fallot in infancy using profound hypothermia with circulatory arrest and limited cardiopulmonary bypass: a comparison with conventional two stage management. Ann Surg. 1973 Oct;178(4):406–411. doi: 10.1097/00000658-197310000-00003. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Baum D., Stern M. P. Adipose hypocellularity in cyanotic congenital heart disease. Circulation. 1977 Jun;55(6):916–920. doi: 10.1161/01.cir.55.6.916. [DOI] [PubMed] [Google Scholar]
  6. Becker A. E., Connor M., Anderson R. H. Tetralogy of Fallot: a morphometric and geometric study. Am J Cardiol. 1975 Mar;35(3):402–412. doi: 10.1016/0002-9149(75)90034-x. [DOI] [PubMed] [Google Scholar]
  7. Bertranou E. G., Blackstone E. H., Hazelrig J. B., Turner M. E., Kirklin J. W. Life expectancy without surgery in tetralogy of Fallot. Am J Cardiol. 1978 Sep;42(3):458–466. doi: 10.1016/0002-9149(78)90941-4. [DOI] [PubMed] [Google Scholar]
  8. Bing R. J. The Johns Hopkins: the Blalock-Taussig era. Perspect Biol Med. 1988 Autumn;32(1):85–90. doi: 10.1353/pbm.1988.0000. [DOI] [PubMed] [Google Scholar]
  9. Carmi R., Boughman J. A. Pentalogy of Cantrell and associated midline anomalies: a possible ventral midline developmental field. Am J Med Genet. 1992 Jan 1;42(1):90–95. doi: 10.1002/ajmg.1320420118. [DOI] [PubMed] [Google Scholar]
  10. Castaneda A. R., Freed M. D., Williams R. G., Norwood W. I. Repair of tetralogy of Fallot in infancy. Early and late results. J Thorac Cardiovasc Surg. 1977 Sep;74(3):372–381. [PubMed] [Google Scholar]
  11. Cooley D. A. Recollections of early development and later trends in cardiac surgery. J Thorac Cardiovasc Surg. 1989 Nov;98(5 Pt 2):817–821. [PubMed] [Google Scholar]
  12. Dietz H. C., Pyeritz R. E. Molecular biology--to the heart of the matter. N Engl J Med. 1994 Mar 31;330(13):930–932. doi: 10.1056/NEJM199403313301311. [DOI] [PubMed] [Google Scholar]
  13. Driscoll D. A., Salvin J., Sellinger B., Budarf M. L., McDonald-McGinn D. M., Zackai E. H., Emanuel B. S. Prevalence of 22q11 microdeletions in DiGeorge and velocardiofacial syndromes: implications for genetic counselling and prenatal diagnosis. J Med Genet. 1993 Oct;30(10):813–817. doi: 10.1136/jmg.30.10.813. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Engle M. A. Dr. Helen B. Taussig, the tetralogy of fallot, and the growth of pediatric cardiac services in the United States. Johns Hopkins Med J. 1977 Apr;140(4):147–150. [PubMed] [Google Scholar]
  15. Freedom R. M., Rosen F. S., Nadas A. S. Congenital cardiovascular disease and anomalies of the third and fourth pharyngeal pouch. Circulation. 1972 Jul;46(1):165–172. doi: 10.1161/01.cir.46.1.165. [DOI] [PubMed] [Google Scholar]
  16. GLENN W. W., PATINO J. F. Circulatory by-pass of the right heart. I. Preliminary observations on the direct delivery of vena caval blood into the pulmonary arterial circulation; azygos vein-pulmonary artery shunt. Yale J Biol Med. 1954 Dec;27(3):147–151. [PMC free article] [PubMed] [Google Scholar]
  17. Garson A., Jr, Nihill M. R., McNamara D. G., Cooley D. A. Status of the adult and adolescent after repair of tetralogy of Fallot. Circulation. 1979 Jun;59(6):1232–1240. doi: 10.1161/01.cir.59.6.1232. [DOI] [PubMed] [Google Scholar]
  18. Gott V. L. And it happened during our lifetime... Ann Thorac Surg. 1993 May;55(5):1057–1064. doi: 10.1016/0003-4975(93)90005-3. [DOI] [PubMed] [Google Scholar]
  19. Gérard R. Un centenaire: la tétralogie de Fallot (1888-1988). Arch Mal Coeur Vaiss. 1988 Nov;81(11):1313–1315. [PubMed] [Google Scholar]
  20. Hewitt R. L., Creech O., Jr History of the pump oxygenator. Arch Surg. 1966 Oct;93(4):680–696. doi: 10.1001/archsurg.1966.01330040144030. [DOI] [PubMed] [Google Scholar]
  21. KIRKLIN J. W., DUSHANE J. W., PATRICK R. T., DONALD D. E., HETZEL P. S., HARSHBARGER H. G., WOOD E. H. Intracardiac surgery with the aid of a mechanical pump-oxygenator system (gibbon type): report of eight cases. Proc Staff Meet Mayo Clin. 1955 May 18;30(10):201–206. [PubMed] [Google Scholar]
  22. Kirby M. L., Gale T. F., Stewart D. E. Neural crest cells contribute to normal aorticopulmonary septation. Science. 1983 Jun 3;220(4601):1059–1061. doi: 10.1126/science.6844926. [DOI] [PubMed] [Google Scholar]
  23. LILLEHEI C. W., COHEN M., WARDEN H. E., VARCO R. L. The direct-vision intracardiac correction of congenital anomalies by controlled cross circulation; results in thirty-two patients with ventricular septal defects, tetralogy of Fallot, and atrioventricularis communis defects. Surgery. 1955 Jul;38(1):11–29. [PubMed] [Google Scholar]
  24. Lammer E. J., Chen D. T., Hoar R. M., Agnish N. D., Benke P. J., Braun J. T., Curry C. J., Fernhoff P. M., Grix A. W., Jr, Lott I. T. Retinoic acid embryopathy. N Engl J Med. 1985 Oct 3;313(14):837–841. doi: 10.1056/NEJM198510033131401. [DOI] [PubMed] [Google Scholar]
  25. Laurenceau J. L., Delisle G., Guay J. M., Gagné S. Etude des tétralogies de Fallot par échocardiographie. Arch Mal Coeur Vaiss. 1975 May;68(5):505–512. [PubMed] [Google Scholar]
  26. McNamara D. G. The role of the pediatric cardiologist in the team approach to cardiac surgery. Cardiovasc Clin. 1972;4(3):319–323. [PubMed] [Google Scholar]
  27. Menon G., Poskitt E. M. Why does congenital heart disease cause failure to thrive? Arch Dis Child. 1985 Dec;60(12):1134–1139. doi: 10.1136/adc.60.12.1134. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Meyer J., Chiariello L., Hallman G. L., Cooley D. A. Coronary artery anomalies in patients with tetralogy of Fallot. J Thorac Cardiovasc Surg. 1975 Mar;69(3):373–376. [PubMed] [Google Scholar]
  29. Murphy J. G., Gersh B. J., Mair D. D., Fuster V., McGoon M. D., Ilstrup D. M., McGoon D. C., Kirklin J. W., Danielson G. K. Long-term outcome in patients undergoing surgical repair of tetralogy of Fallot. N Engl J Med. 1993 Aug 26;329(9):593–599. doi: 10.1056/NEJM199308263290901. [DOI] [PubMed] [Google Scholar]
  30. Olley P. M., Coceani F., Bodach E. E-type prostaglandins: a new emergency therapy for certain cyanotic congenital heart malformations. Circulation. 1976 Apr;53(4):728–731. doi: 10.1161/01.cir.53.4.728. [DOI] [PubMed] [Google Scholar]
  31. POLANI P. E., CAMPBELL M. An aetiological study of congenital heart disease. Ann Hum Genet. 1955 Feb;19(3):209–230. doi: 10.1111/j.1469-1809.1955.tb01345.x. [DOI] [PubMed] [Google Scholar]
  32. Patterson D. F., Pexieder T., Schnarr W. R., Navratil T., Alaili R. A single major-gene defect underlying cardiac conotruncal malformations interferes with myocardial growth during embryonic development: studies in the CTD line of keeshond dogs. Am J Hum Genet. 1993 Feb;52(2):388–397. [PMC free article] [PubMed] [Google Scholar]
  33. Pyeritz R. E., Murphy E. A. Genetics and congenital heart disease: perspectives and prospects. J Am Coll Cardiol. 1989 Jun;13(7):1458–1468. doi: 10.1016/0735-1097(89)90333-1. [DOI] [PubMed] [Google Scholar]
  34. Quattlebaum T. G., Varghese J., Neill C. A., Donahoo J. S. Sudden death among postoperative patients with tetralogy of Fallot: a follow-up study of 243 patients for an average of twelve years. Circulation. 1976 Aug;54(2):289–293. doi: 10.1161/01.cir.54.2.289. [DOI] [PubMed] [Google Scholar]
  35. RICHARDSON D. A history of the morbus caeruleus. Bull Hist Med. 1962 May-Jun;36:193–219. [PubMed] [Google Scholar]
  36. Rabinovitch M., Herrera-deLeon V., Castaneda A. R., Reid L. Growth and development of the pulmonary vascular bed in patients with tetralogy of Fallot with or without pulmonary atresia. Circulation. 1981 Dec;64(6):1234–1249. doi: 10.1161/01.cir.64.6.1234. [DOI] [PubMed] [Google Scholar]
  37. Rashkind W. J., Wagner H. R., Tait M. A. Historical aspects of interventional cardiology: past, present and future. Tex Heart Inst J. 1986 Dec;13(4):363–367. [PMC free article] [PubMed] [Google Scholar]
  38. Report of the New England Regional Infant Cardiac Program. Pediatrics. 1980 Feb;65(2 Pt 2):375–461. [PubMed] [Google Scholar]
  39. Rome J. J., Mayer J. E., Castaneda A. R., Lock J. E. Tetralogy of Fallot with pulmonary atresia. Rehabilitation of diminutive pulmonary arteries. Circulation. 1993 Oct;88(4 Pt 1):1691–1698. doi: 10.1161/01.cir.88.4.1691. [DOI] [PubMed] [Google Scholar]
  40. Ross D. N., Somerville J. Correction of pulmonary atresia with a homograft aortic valve. Lancet. 1966 Dec 31;2(7479):1446–1447. doi: 10.1016/s0140-6736(66)90600-3. [DOI] [PubMed] [Google Scholar]
  41. Santoro G., Marino B., Di Carlo D., Formigari R., de Zorzi A., Mazzera E., Rinelli G., Marcelletti C., De Simone G., Pasquini L. Echocardiographically guided repair of tetralogy of Fallot. Am J Cardiol. 1994 Apr 15;73(11):808–811. doi: 10.1016/0002-9149(94)90885-0. [DOI] [PubMed] [Google Scholar]
  42. Senning A. Developments in cardiac surgery in Stockholm during the mid and late 1950s. J Thorac Cardiovasc Surg. 1989 Nov;98(5 Pt 2):825–832. [PubMed] [Google Scholar]
  43. Shprintzen R. J., Goldberg R. B., Young D., Wolford L. The velo-cardio-facial syndrome: a clinical and genetic analysis. Pediatrics. 1981 Feb;67(2):167–172. [PubMed] [Google Scholar]
  44. Taussig H. B. Evolutionary origin of cardiac malformations. J Am Coll Cardiol. 1988 Oct;12(4):1079–1086. doi: 10.1016/0735-1097(88)90479-2. [DOI] [PubMed] [Google Scholar]
  45. Taussig H. B., Kallman C. H., Nagel D., Baumgardner R., Momberger N., Kirk H. Long-time observations on the Blalock-Taussig operation VIII. 20 to 28 year follow-up on patients with a tetralogy of Fallot. Johns Hopkins Med J. 1975 Jul;137(1):13–19. [PubMed] [Google Scholar]
  46. Taussig H. B. Neuhauser Lecture: Tetralogy of Fallot: early history and late results. AJR Am J Roentgenol. 1979 Sep;133(3):422–431. doi: 10.2214/ajr.133.3.422. [DOI] [PubMed] [Google Scholar]
  47. Torii S., Suma K., Miyawaki F., Shiroma K., Inoue K. [Postoperative long-term quality of life at present after total correction of tetralogy of Fallot]. Kyobu Geka. 1990 Jul;43(8):620–624. [PubMed] [Google Scholar]
  48. Van Praagh R. Etienne-Louis Arthur Fallot and his tetralogy: a new translation of Fallot's summary and a modern reassessment of this anomaly. Eur J Cardiothorac Surg. 1989;3(5):381–386. doi: 10.1016/1010-7940(89)90044-4. [DOI] [PubMed] [Google Scholar]
  49. Vobecky S. J., Williams W. G., Trusler G. A., Coles J. G., Rebeyka I. M., Smallhorn J., Burrows P., Gow R., Freedom R. M. Survival analysis of infants under age 18 months presenting with tetralogy of Fallot. Ann Thorac Surg. 1993 Oct;56(4):944–950. doi: 10.1016/0003-4975(93)90361-k. [DOI] [PubMed] [Google Scholar]
  50. Voisin M., Doan B., Elboury S., Messner P., Chaptal P. A., Grolleau R., Astruc J., Jean R. Malformations extracardiaques dans la tétralogie de Fallot. Arch Mal Coeur Vaiss. 1989 May;82(5):689–692. [PubMed] [Google Scholar]
  51. Warden H. E. C. Walton Lillehei: pioneer cardiac surgeon. J Thorac Cardiovasc Surg. 1989 Nov;98(5 Pt 2):833–845. [PubMed] [Google Scholar]
  52. Whittemore R., Hobbins J. C., Engle M. A. Pregnancy and its outcome in women with and without surgical treatment of congenital heart disease. Am J Cardiol. 1982 Sep;50(3):641–651. doi: 10.1016/0002-9149(82)90334-4. [DOI] [PubMed] [Google Scholar]

Articles from Texas Heart Institute Journal are provided here courtesy of Texas Heart Institute

RESOURCES