The Revelation of Spontaneous Correction of Malalignment Ventricular Septal Defect and Overriding of the Aorta in a Child with Pink Tetralogy of Fallot



Ashish Shrivastava MD1*, Snigdha Bhatia MD2, Sanjeev Aggarwal MD2, Raya Safa MD2

1The Heart Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio 45229, USA

2Division of Pediatric Cardiology, Department of Pediatrics, Children’s Hospital of Michigan, Detroit, MI, USA.

*Corresponding Author: Ashish Shrivastava, Department of Pediatric Cardiology, Cincinnati Children’s Hospital Medical Center 3333 Burnet Ave, Cincinnati, Ohio-45220, USA.

https://doi.org/10.58624/SVOAPD.2025.04.003

Received: February 03, 2025

Published: February 22, 2025

Citation: Shrivastava A, Bhatia S, Aggarwal S, Safa R. The Revelation of Spontaneous Correction of Malalignment Ventricular Septal Defect and Overriding of the Aorta in a Child with Pink Tetralogy of Fallot. SVOA Paediatrics 2025, 4:1, 13-16. doi: 10.58624SVOAPD.2025.04.003

 

Abstract

Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart disease. The presentation and treatment approach depends on the severity of the right ventricular outflow tract obstruction, and most cases require a surgical correction. We describe a neonate with pink TOF who exhibited typical echocardiographic characteristics such as aortic overriding, and a large VSD with minimal or no pulmonary outflow tract obstruction. The patient lost to follow-up, and a repeat 5-year echocardiogram revealed the absence of aortic overriding and significantly restricted VSD with a left-to-right shunt (pressure gradient ~50 mmHg across the VSD). There is no previous evidence of spontaneous correction of the defects associated with TOF which makes this case so intriguing.

Keywords: Tetralogy of Fallot, Ventricular septal defect, Echocardiogram