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In this condition, episodic worsening of hypoxemia results from dynamic shifts in physiology, so-called \u201cTet spells.\u201d The relative frequency of this lesion and the risks of exacerbating \u201cTet spells\u201d make anesthetic management of this patient population challenging. The conduct of palliative and reparative cardiac surgery is determined in large part by the anatomic variations within the spectrum of this disorder, most notably the severity of right ventricular outflow tract obstruction. This review will address the impact that the anatomic substrate has on the perioperative management of this interesting patient population.<\/jats:p>","DOI":"10.1177\/1089253211434566","type":"journal-article","created":{"date-parts":[[2012,1,24]],"date-time":"2012-01-24T21:01:59Z","timestamp":1327438919000},"page":"88-96","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":11,"title":["Tetralogy of Fallot"],"prefix":"10.1177","volume":"16","author":[{"given":"Angela M.","family":"Sharkey","sequence":"first","affiliation":[{"name":"Saint Louis University, St. Louis, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anshuman","family":"Sharma","sequence":"additional","affiliation":[{"name":"Washington University, St. Louis, MO, 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