Background: Congenital heart disease is the most prevalent form of primary congenital disability in newborns and is the leading cause of death in children with congenital malformations. It occurs in approximately 0.8% of live births. With advances in both palliative and corrective surgery, the number of children with congenital heart disease surviving to adulthood has increased dramatically . Tetralogy of Fallot (TOF) is one of the conotruncal
family of heart lesions in which the primary defect is an anterior deviation of the infundibular septum (the muscular septum that separates the aortic and pulmonary outflows). Objective: To revise patients with tetralogy of Fallot (TOF) underwent palliative or total corrective surgical repair in Madinah, Saudi Arabia. Methods: retrospective study was approved from the institutional review board of Madinah cardiac center and abandoned the need for patient consent. Patient Demographic data and procedure details were retrieved from the hospital information system (HIS). From 2014 till end of 2017, 72 patients had the diagnosis of TOF (ICD 10 code, Q21.3). Twelve patients were excluded from them. Thus, 60 patients were left as the study cohort. Fifty four patients had total repair from the start (Group I), 3 patients had initial palliative procedure (group II) and 3 patients had both initial palliative procedure then later total repair. All patients from 1 day to less than 14 years are included. All data were analyzed using GraphPad prism version 5.00 for windows. Results: 61.67% of our patients were males, and 38.33% were females with the ratio of 1.6 (Male: Female). Six (10%) cases were subjected to a palliative correction surgery (group I) and 57 (95%) cases were subjected to total repair surgery (group II). 11 (18.3%) cases had post-operative complications, 2 (18.2%) cases from group I and 9 (81.8%) cases from group II. Regarding to the type of surgery there was no statistically significant difference between gender and pre and post-operation stay. Also no significance with length of stay, re-intervention, mortality and complications. While there was a significant correlation between age, weight, RPA and LPA. Conclusion: In our cohort of TOF patients the incidence of the disease was higher among males than females. The continuous follow up was highly recommended for TOF patients. The outcomes of surgical treatment including palliative, total and intervention correction surgeries was a complete recovery of 28.33% of studied patients, and the remaining (71.67%) had post-surgical complications.