Looking to the Left to Get It Right: Left Ventricular Systolic Dysfunction and Risk Stratification Late After Tetralogy of Fallot Repair

Much of the tetralogy of Fallot (TOF) story has been told from the perspective of the right heart. Embryologically, TOF develops as a right heart obstructive lesion arising secondary to anterior and superior deviation of the infundibular septum. Consequently, the anatomic substrate at birth, surgical repair in early childhood, and sequelae in later life are determined by early development and subsequent integrity of the right ventricular outflow...