Use of angled hegar dialator for antegrade sizing of the right ventricular outflow tract in tetralogy of Fallot.

During transatrial-transpulmonary repair of tetralogy of Fallot, one of the challenges is accurately sizing the right ventricular (RV) outflow tract diameter, including the pulmonary annulus in an antegrade manner through the right atrium. This is due to the almost 90° angle between the long axis of the RV inflow through the tricuspid valve and the RV outflow through the pulmonary valve. The angled Hegar dialator, helps to accurately size the right ventricular outflow tract from the right atrium through the tricuspid valve in an antegrade manner.