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Abstract
The tetralogy of Fallot (TOF) is considered one of the most common congenital cyanotic heart diseases. It comprises right ventricular outflow tract obstruction, ventricular septal defect, overriding of the aorta and right ventricular hypertrophy. (1,2,3) The development of cardiopulmonary pulmonary bypass machine and the improvement in the surgical techniques have made it possible to not only do a palliative shunt but also a total primary repair could be done safely. Nowadays the survival rates of these patients have risen to a great extent and that led to the development of an adult population with repaired Fallot, however some complications can still affect such patients including neurological insults. In the trials to reduce complications affecting the TOF patients, many efforts are being directed towards improving the perioperative period, among these efforts are better methods being developed in the intra and postoperative monitoring of these patients. Monitoring of cerebral oxygenation intraoperatively can help to reduce neurological hazards and to improve outcome