A novel PITX2 mutation (p.Q102L) was identified in a family with tetralogy of Fallot.
The mutation co-segregated with tetralogy of Fallot with complete penetrance.
The mutation was absent in 600 reference chromosomes.
The mutant PITX2 had a significantly reduced transcriptional activity.
The mutation markedly decreased the synergistic activation between PITX2 and NKX2-5.