Describe the pathophysiology of congenital cardiac defects with decreased pulmonary blood flow, including mechanisms of right-to-left shunting, reduced pulmonary circulation, and the development of cyanosis.

Explain the clinical consequences of chronic cyanosis, including clubbing, polycythemia, coagulation abnormalities, thrombotic risk, and susceptibility to cardiovascular complications.

Apply assessment findings to recognize hypercyanotic spells and identify precipitating factors, clinical manifestations, and physiologic mechanisms contributing to these events.

Analyze the structural abnormalities, hemodynamic consequences, and surgical repair strategies associated with Tetralogy of Fallot and transposition of the great arteries.

Evaluate postoperative findings and potential complications following surgical correction of Tetralogy of Fallot and transposition of the great arteries, including residual defects, ventricular dysfunction, arrhythmias, and coronary artery complications.