This monograph on the adult with tetralogy of Fallot (TOF) is the first of a series dedicated to common topics in adult congenital cardiac disease (CHD). Published under the auspices of the International Society of Adult Congenital Cardiac Disease (ISACCD), the monograph provides comprehensive, timely review of the adult with TOF, the most common form of cyanotic CHD. The 6 chapters of the monograph, written by international authorities in the field, contain background information and current data on the major clinical problems facing adults with TOF. Patients born with TOF, although "fixed," are not "cured." Improving survival and quality of life for this ever-increasing adult population will continue to challenge the current and future generations of cardiologists. This monograph is intended as both an introduction to the subject and a timely, comprehensive review, more extensive than a review article and more up-to-date than a textbook. As such, this monograph should be of interest to the internist and the cardiologist who find themselves encountering adults with congenital heart defects with increasing frequency in their practice. Key references provided at the end of each chapter present the relevant literature, allowing for further reading.