Staged interventional and surgical treatment of tetralogy of Fallot with critical stenosis of proximal aortic arch in premature hypotrophic newborn

Tetralogy of Fallot (ToF) is the most common cyanotic congenital heart defect diagnosed in newborns. Depending on the degree of right ventricle outflow tract stenosis and clinical signs of cyanosis, the pathology necessitates intensive medical, interventional and surgical treatment in early infancy with anatomic correction before the first year of life. ToF is often accompanied by additional cardiovascular defects and congenital abnormalities apart from the circulatory system. Complex stenosis of the right ventricle outflow tract (RVOT) in ToF is rarely accompanied by any stenosis of the left ventricle outflow structures [1]. Regular treatment becomes more problematic in borderline low body weight patients suffering from prematurity and hypotrophy (birth weight < 2.5 kg), who usually do not meet regular criteria for surgery and cardiac interventions.