Tetralogy of Fallot_A7856

**Tetralogy of Fallot** The congenital malformations of the heart and great vessels include status post-operative closure of the ventricular septal defect (high membranous) and insertion of prosthetic pulmonary valve (absent pulmonary valve) with pericardial patch enlargement of the right ventricular outflow tract. Additionally, the right ventricle was massively hypertrophied with enlarged pulmonary artery and branches with pulmonary vascular hypertensive changes, massive right ventricular hypertrophy, right-sided aortic arch resulting in a reversal of the normal brachiocephalic distribution, and absent ductus arteriosus.