Tetralogy of Fallot Correction

Tetralogy of Fallot correction (TOF correction) is a surgical procedure used to fix several congenital heart defects (present at birth). These defects affect the structure of the heart and cause oxygen-poor blood to flow out of the heart and to the rest of the body. When oxygen-poor blood is pumped to the body, the fingers, toes, and lips may appear blue. This condition is called cyanosis. Other symptoms may include shortness of breath and rapid breathing, clubbing of fingers and toes (thickening of the nail bed, causing the nail to curve downward), poor weight gain, and irritability. It is often diagnosed during infancy or soon after. Repairing the defects can greatly improve the child’s health and quality of life. 

Tetralogy of Fallot is characterized by four heart defects which include:
  • Ventricular septal defect (hole between the lower chambers of the heart)
  • Pulmonary stenosis (narrowing of the pulmonary valve and outlet from the right ventricle to the pulmonary artery)
  • Overriding aorta (the aorta is shifted to the right and sits over the ventricular septal defect, instead of being attached to the left ventricle)
  • Right ventricular hypertrophy (thickening of the heart muscle)
The timing of surgery depends on symptoms but is usually performed within the first 2 years of life
The risks for tetralogy of Fallot correction include the following:
  • Bleeding
  • Arrhythmias (irregular heartbeat)
  • Adverse reaction to medications
  • Chronic pulmonary regurgitation (leaking valve)
  • Blood clots that can lead to stroke, heart attack, or other complications
  • Infection
  • Need for re-operation
  • Death
The success of the procedure depends on a number of factors. Please discuss the likelihood of success with the doctor before the procedure.
What if this procedure is not performed?
Surgery is the only effective treatment for tetralogy of Fallot. Untreated cases usually develop severe complications over time, which may result in death or disability by early adulthood.
Medication and Blalock-Taussig shunt (temporary surgery sometimes needed if the child is too weak or too small for the full repair)

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