TOF treatment:

Open-heart surgery to rectify the abnormalities (intracardiac repair) or a temporary technique using a shunt are also options for tetralogy of Fallot surgery. Intracardiac repair is performed on the majority of newborns and older children.

This open-heart surgery, which requires many repairs, is normally performed within the first year of a child's life. Adults with tetralogy of Fallot who did not have surgical correction as children may be candidates for this surgery.

The surgeon will patch over the ventricular septal defect to cover the opening between the lower chambers of the heart (ventricles) during intracardiac repair. Increase blood flow to the lungs by repairing or replacing the constricted pulmonary valve.

Disease Overview

Tetralogy of Fallot

Tetralogy of Fallot is a congenital cardiac ailment that consists of four congenital heart abnormalities. A ventricular septal defect (VSD), pulmonary stenosis, a misplaced aorta, and a thicker right ventricular wall are the four defects (right ventricular hypertrophy). They generally result in an insufficient supply of oxygen-rich blood to the body.

It's a congenital condition that prevents regular blood flow through the heart. It occurs when a baby's heart does not form properly during pregnancy when the infant grows and develops in the mother's womb.

Disease Signs and Symptoms:

Symptoms of Tetralogy of Fallot vary depending on how much blood flow is obstructed. The following are possible signs and symptoms:

• Low blood oxygen levels create a blue tint of the skin (cyanosis)
• Rapid breathing and shortness of breath, especially during food or activity
• Weight growth is poor.
• Playing or exercising might be exhausting.
• Irritability
• Crying for a long time
• Fainting due to a heart murmur
• The nail bed of the fingers and toes has an irregular, rounded form (clubbing)

Disease Causes:

Tetralogy of Fallot happens during the development of the baby's heart during pregnancy. In most cases, the cause is unknown.

Fallot tetralogy is made up of four defects:

• The valve in the lungs narrows (pulmonary valve stenosis).
• A gap between the bottom chambers of the heart (ventricular septal defect)
• The major artery of the body shifts (aorta).
• The right lower heart chamber is thickening (right ventricular hypertrophy).

Some infants and adults with tetralogy of Fallot may also have additional heart abnormalities, such as an atrial septal defect (hole between the upper chambers of the heart), a right aortic arch, or coronary artery issues.

Risk factors can be:

• A viral disease during pregnancy, such as rubella, is a risk factor for tetralogy of Fallot (German measles)
• Consumption of alcoholic beverages when pregnant.
• Poor nutrition during pregnancy.
• A mother who is over the age of 40.
• A parent who has tetralogy of Fallot.
• In the case of an infant, the existence of Down syndrome or DiGeorge syndrome.

Disease Diagnosis:

Tetralogy of Fallot is usually diagnosed shortly after birth. It's possible that your baby's skin will seem blue. When a doctor listens to the baby's heart using a stethoscope, he or she may detect an abnormal whooshing sound (heart murmur).

The following tests can be used to diagnose tetralogy of Fallot:

Measurement of oxygen levels (pulse oximetry). The quantity of oxygen in the blood is measured by a tiny sensor attached to a finger or toe.

Echocardiogram. Sound waves are used in an echocardiogram to produce images of the heart in action. The anatomy, positioning, and function of the heart wall, heart chambers, heart and pulmonary valves, and aorta may all be seen on an echocardiography.

An EKG is a type of electrocardiogram (ECG or EKG). When the heart contracts, an electrocardiogram captures the electrical activity. Sticky patches containing wires (electrodes) are applied to the chest, wrists, and ankles during this surgery. The cables are connected to a computer that shows the heartbeat. An ECG can reveal whether the heart chambers are enlarged or whether the heartbeat is irregular (arrhythmia).

X-ray of the chest. The structure of the heart and lungs may be seen on a chest X-ray. Because the right ventricle is enlarged, a boot-shaped heart is a typical X-ray symptom of tetralogy of Fallot.

Catheterization of the heart. This test can be used by doctors to assess the anatomy of the heart and plan surgical therapy. A thin, flexible tube (catheter) is inserted into a blood artery, generally in the groyne, and guided to the heart during this surgery.

Dye is injected into the catheter to let X-rays view the cardiac components more clearly. During the operation, the doctor can monitor pressure and oxygen levels in the heart's chambers and blood arteries.

Disease Treatment

A heart (cardiovascular) surgeon must conduct corrective surgery on all newborns with tetralogy of Fallot. Your baby's growth and development may be stunted if you don't treat him or her. Based on your or your child's health, your doctor will select the most appropriate procedure and the scheduling of the surgery.

While waiting for surgery, some children may require medication to keep blood flowing from the heart to the lungs.

Surgical or non-surgical techniques

Open-heart surgery to rectify the abnormalities (intracardiac repair) or a temporary technique using a shunt are also options for tetralogy of Fallot surgery. Intracardiac repair is performed on the majority of newborns and older children.

Repairing the inner lining of the heart

This open-heart surgery, which requires many repairs, is normally performed within the first year of a child's life. Adults with tetralogy of Fallot who did not have surgical correction as children may be candidates for this surgery.

The surgeon will do the following during intracardiac repair:

To seal the hole between the lower chambers of the heart, apply a patch over the ventricular septal defect (ventricles).

Increase blood flow to the lungs by repairing or replacing the constricted pulmonary valve.

Because the right ventricle will no longer have to work as hard to pump blood following this treatment, the thickness of the right ventricle wall will return to normal. The oxygen level in the blood rises after intracardiac repair, and symptoms fade.

Surgery for a temporary shunt

In order to increase blood flow to the lungs, newborns may need to have a temporary (palliative) surgery before having intracardiac repair. If your infant was born preterm or has underdeveloped pulmonary arteries, this operation may be performed (hypoplastic).