Tetralogy of fallot (TOF) is the most common cyanotic congenital heart disease. Anatomical variations occurring in these patients often contribute to postoperative morbidity and affect the long term outcome. However, there is limited literature discussing the perioperative imaging and management of these variations. In this review, we highlight the common anatomical variations we encountered at our institute during routine perioperative echocardiography. Discussion of these with the operating team helped us in improving the surgical outcome.
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