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Tetralogy of Fallot 


What is Tetralogy of Fallot?

Tetralogy of Fallot is a congenital heart defect that involves a combination of four abnormalities in the heart that affects blood flow to the lungs.

The Four Abnormalities in Tetralogy of Fallot

1. Ventricular septal defect

There is a hole between the two bottom chambers (ventricles) of the heart. This is usually a single, large hole.

2. Overriding aorta

The aorta straddles over the ventricular septum. This is called “override.”

3. Pulmonary Valvar and Infundibular Steosis

There is narrowing where blood flows out of the right ventricle to the lungs. The narrowing varies from person to person, ranging from minor to severe.

4. Right ventricular hypertrophy

Over time, the right ventricle becomes more muscular due to the pulmonary artery narrowing.

 

How is Tetralogy of Fallot diagnosed during pregnancy?

If your physician suspects a heart defect, a fetal cardiologist will perform a fetal echocardiogram to view the heart and its anatomy. With this imaging the Fetal Heart Program team can see the severity of the heart defect, and put together a plan for the best course of action.

How is Tetralogy of Fallot managed during pregnancy?

After diagnosing Tetralogy of Fallot during your pregnancy, our team monitors your baby closely during pregnancy and helps prepare for delivery. Some babies with Tetralogy of Fallot may need surgery in the neonatal period, but many others may not require surgery until four to six months of age.

 How does Tetralogy of Fallot impact delivery?

Most babies with Tetralogy of Fallot can be delivered vaginally unless otherwise indicated by your obstetrician . It is best for these babies to be delivered at a medical center where there is immediate access to a team of pediatric cardiologists and neonatologists, along with an established NICU (Neonatal Intensive Care Unit). 

How will Tetralogy of Fallot affect my child after delivery? 

Your baby may have bluish skin because of decreased oxygen in the blood. Other symptoms may include difficulty feeding, poor weight gain and blue (TET) spells,. Tetralogy of Fallot can be associated with other conditions such as Down Syndrome or DiGeorge Syndrome.

What are the treatments and surgeries for Tetralogy of Fallot?

The type of treatments and surgery necessary depends on the severity of the heart defect. For patients with the most severe variant, the surgeon can create a shunt shortly after birth. This shunt will help provide more stable oxygen levels. Complete repair will be performed later in infancy. For those that do not require a shunt, total surgical repair will be performed around four to six months of age.

What happens after surgery?

Many children who have had surgery to treat Tetralogy of Fallot recover and grow normally. Depending on how severe the heart defect is, your child may need additional surgeries, medications, or other treatments later in life.

What is the long-term prognosis for children with Tetralogy of Fallot?

The long-term prognosis after surgery for Tetralogy of Fallot is very good in most cases. After total surgical repair, most patients have good or even excellent cardiac function and can exercise normally. In fact, Olympic snowboarder Shaun White and Australian cricketer Beau Casson are two examples of children born with Tetralogy of Fallot who are now world-class athletes!