Congenital heart disease (CHD) is the most common birth defect and in most cases idiopathic. Genetic causes account for up to 35% of patients with CHD  are linked to increased operative risk and mortality . One of the most common genetic abnormalities is a deletion in 22q11 , which affect 1 in 2,000-4,000 live births. This results in a wide spectrum of phenotypes including CHD, palatal abnormalities, immunodeficiency, hypoparathyroidism, dysmorphic facies, and developmental delay . Conotruncal abnormalities are the most common cardiac defects and are found in 75% of patients with 22q11 deletions . Deletions in 22q11 are found in 15% of patients with tetralogy of Fallot (TOF) , 50% with interrupted aortic arch (IAA), and 35% with truncus arteriosus (TA) . Conoventricular ventricular septal defects (VSD) are associated with 22q11 deletion in roughly 5% of patients .