Surgical repair of tetralogy of Fallot: the quest for the ‘ideal’ repair

After more than 40 years’ experience with surgical repair of tetralogy of Fallot (TOF), the focus centralized on the growing evidence that longstanding pulmonary insufficiency is deleterious for right ventricular function and clinical outcome. This subsequently enhanced the search for surgical techniques aiming to relief the right ventricular outflow tract (RVOT) obstruction, while minimizing the degree of pulmonary regurgitation (PR).