Étienne-Louis Arthur Fallot (1850–1911)

Étienne-Louis Arthur Fallot was a physician working in France during the late nineteenth century who studied and described the four cardiac anatomical defects that cause the congenital anomaly known as the Tetralogy of Fallot. Those four heart defects result in deoxygenated blood recirculating through the body, giving the skin a blue-like color, a process called cyanosis. Numerous physicians and researchers before Fallot had identified and described the anatomical cardiac defects that would eventually be included in the Tetralogy. However, Fallot was among the first to note that the four anatomical heart defects tended to occur together. Through autopsy investigations, Fallot established the Tetralogy as one unified pathology rather than four unrelated anatomical abnormalities, providing a basis for the eventual surgical treatment of the condition, which affects approximately four out of every one thousand births worldwide.

Fallot was born in Sète, France, on 29 September 1850 to Jeanne Amelie Constant and Louis Alfred Edouard Fallot. Fallot’s education began at a lycée, or a secondary school intended to prepare students for university, in Marseille, France. During his time at the lycée, Fallot received awards for his academic achievements. Fallot then attended the University of Marseille for medical school, which is called the Aix-Marseille University as of 2025, in Marseille, France. He graduated from the university in 1876. In 1883, he became an intern at the Hospital of Marseille in Marseille. Also, in 1883, he became an assistant professor of forensic medicine and hygiene at the University of Marseille. Soon after, he began teaching pathological anatomy and became clinical chief at the Hôtel-Dieu in Paris, France. While at the Hôtel-Dieu, his chief professor allowed him to perform autopsies. The autopsies that Fallot conducted allowed him to better understand the anatomy of the Tetralogy of Fallot. In particular, while examining those autopsies, Fallot found commonalities among patients who had cyanosis that allowed him to describe the Tetralogy.

Fallot was not the first to observe the anatomical anomalies that occur in the Tetralogy. In 1671, Niels Stensen, also called Nicolas Steno, who was a scientist in Denmark, described a heart with defects similar to what Fallot described. Then, in 1777, Eduard Sandifort, a physician in the Netherlands described the case of a boy who had symptoms of fainting, heart palpitations, and cyanosis as a child, who, upon post-mortem examination, had the defects Steno described. Physicians throughout the late eighteenth and nineteenth centuries added to the description of what researchers later called the Tetralogy of Fallot. However, Fallot was one of the first to detail and unify the Tetralogy as one condition and differentiate it from other cyanotic cardiac conditions.

In 1888, Fallot published a research paper in the journal Marseille Médicale titled “Contribution á l’Anatomie pathologique de la Maladie bleue (Cyanose cardiaque)” (Contribution to the Pathological Anatomy of Blue Disease), in which he described the four anatomical cardiac defects he observed across multiple patients with cyanosis. In his paper, Fallot describes observing pulmonary valve stenosis, which is a narrowing of the valve that transports blood from the heart to the lungs. The narrowing of the pulmonary valve leads to less blood flowing to the lungs for reoxygenation. Another defect that Fallot observed was the ventricular septal defect, which is a small opening present between the two lower heart chambers. The third defect Fallot noted was an overriding aorta, which is when the aorta, one of the main arteries of the heart, is in a different position than what is typical. The last defect that Fallot described was right ventricular hypertrophy, which is a thickening of the walls in the right lower heart chamber.

After his research on the Tetralogy of Fallot in 1888, Fallot became a professor of hygiene and legal medicine at the University of Marseille, where he conducted studies on topics such as regional outbreaks of cholera, as well as on encephalitis, or inflammation of the brain. According to Marios Loukas and colleagues, writing in the journal Clinical Anatomy in 2014, Fallot requested not to have an obituary published after his death. As a result, Fallot’s achievements and research after his work on the Tetralogy are largely unknown.

Over a decade after Fallot’s death, in 1924, physician Maude Elizabeth Seymour Abbott along with Wilfred T. Dawson used the term Tetralogy of Fallot, honoring Fallot and further describing anatomical nuances regarding the overriding aorta. Then, in 1944, physician Alfred Blalock designed and conducted one of the first surgeries for Tetralogy of Fallot, in which he inserted a specialized shunt, or small artificial tube, that allows for the blood to flow to the lungs and become oxygenated. Researchers refer to the shunt as the Blalock-Taussig Shunt. As of 2025, ninety-five percent of infants born with the Tetralogy of Fallot who have surgery to fix the condition survive into adulthood.

Fallot died on 30 April 1911 in Sète.

Sources

1. Allwork, S.P. “Tetralogy of Fallot: The Centenary of the Name. A New Translation of the First of Fallot’s Papers.” European Journal of Cardio-Thoracic Surgery 2 (1988): 386–92.
2. ACS Archives. “Alfred Blalock, MD, FACS, 1899–1964.” American College of Surgeons. https://www.facs.org/about-acs/archives/past-highlights/blalockhighlight/ (Accessed June 17, 2025).
3. Berry, Diana. “History of Cardiology: Etienne-Louis Fallot, MD.” Circulation 114 (2006): f152.
4. Centers for Disease Control and Prevention. “Congenital Heart Defects (CHDs).” CD Centers for Disease Control and Prevention C. https://www.cdc.gov/heart-defects/about/tetralogy-of-fallot.html (Accessed June 17, 2025).

5. Geneanet. “Blanche Amélie Adeline FALLOT.” Geneanet. https://gw.geneanet.org/pierfit?lang=en&p=blanche+amelie+adeline&n=fallot (Accessed June 17, 2025).

    

6. Loukas, Marios, Alper Cesmebasi, Duong Le, Denzil Etienne, R. Shane Tubbs, and Robert H. Anderson. “Etienne-Arthur Louis Fallot and His Tetralogy.” Clinical Anatomy 27 (2014): 958–63.
7. Niell, C.A., and E.B. Clark. “Tetralogy of Fallot. The First 300 Years.” The Texas Heart Institute Journal 21 (1994): 272–9.
8. Smith, Clayton A., Courtney McCracken, Amanda S. Thomas, Logan G. Spector, James D. St Louis, Matthew E. Oster, James H. Moller, and Lazaros Kochilas. “Long-Term Outcomes of Tetralogy of Fallot: A Study From the Pediatric Cardiac Care Consortium.” JAMA Cardiology 4 (2019): 34–41. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6439686/ (Accessed June 17, 2025).
9. Stanford Medicine. “Blalock-Taussig Shunt.” Stanford Medicine. https://stanfordhealthcare.org/medical-conditions/blood-heart-circulation/single-ventricle/treatments/blalock-taussig-shunt.html (Accessed June 17, 2025).
10. Talbott, John Harold. A Biographical History of Medicine: Excerpts and Essays on the Men and Their Work. New York: Grune and Stratton, 1970.
11. Van Praagh, Richard. “The First Stella van Praagh Memorial Lecture: The History and Anatomy of Tetralogy of Fallot.” Seminars in Thoracic and Cardiovascular Surgery: Pediatric Cardiac Surgery Annual 12 (2009): 19–38.