Perioperative Challenges of Unrepaired Tetralogy of Fallot in a Child With Severe Secondary Erythrocytosis: Lessons for the Modern Era

In the United States, secondary erythrocytosis in children with unrepaired Tetralogy of Fallot (ToF) is rare yet may present in children from underresourced environments. We report our experience caring for a 5-year-old male with unrepaired ToF from a low-resourced country presenting with a hematocrit of 76.2%, requiring unique perioperative considerations. This work aligns with the unifying mission among congenital heart providers to improve access to high-quality surgery globally through collaboration.