Tetralogy of Fallot (TOF) refers to a congenital heart defect, which involves four anatomical anomalies of the heart – ventricular septal defect (VSD), aortic valve overriding the ventricular septum, narrowing of the right ventricular outflow tract (RVOT) and the pulmonary valve and artery, and right ventricular hypertrophy (RVH).
The condition involves a right-to-left shunt, which leads to higher resistance to right ventricular outflow, which leads in more severe cyanotic symptoms. As a result, Tetralogy of Fallot is known as the most common cyanotic heart defect and the most common cause of blue baby syndrome.
According to the Centers for Disease Control and Prevention (CDC), it is estimated that each year, about 1,660 babies in the United States are born with Tetralogy of Fallot. This suggests that about one in every 2,518 babies born in the United States each year have the medical condition. As per the publication, while the prime causes of heart defects in infants are unknown, some factors that are believed to cause the condition include certain genetic or chromosomal combinations and the kind of lifestyle the mother had during pregnancy.
Tetralogy of Fallot is usual diagnosed during the infancy stage or soon and it might not be detected until later in life, since the severity of the effects and the symptoms have to be taken into consideration, as per Mayo Clinic. The early diagnosis is usually followed by appropriate surgical treatment, so most children who suffer from the condition live faily normal lives among others. However, these children still need consistent health care, with some limitations on physical activities.
Surgery stands as the only efficient treatment for Tetralogy of Fallot, as per Mayo Clinic. The procedure involves like temporary surgery for intercardiac repair. Temporary surgery is done before the intercardiac repair and this involves the creation of a bypass shunt between a large artery that branches off from the pulmonary artery and the aorta. This aims to boos blood flow to the lungs. Once the child is ready for intercardiac repair, the surgeon will remove the shunt during the reparative phase of the procedure.
Open-heart surgery is usually done during the first year after birth. A patch is placed over the ventricular septal defect to close the hole between the heart’s lower chambers, the ventricles. The narrowed pulmonary valve is also replaced and repaired while the pulmonary arteries are widened to enhance blood circulation in the lungs. Following the intercardiac repair, the oxygen level in the blood goes high, reducing the symptoms of the medical condition.
The overall management of Tetralogy of Fallot involves feeding and nutrition, activity restrictions, and tet spells management. According to National Heart, Lung, and Blood Institute, infants with the condition can be tired while nursing or feeding; thus, small, frequent meals can be easier for the baby to swallow and digest. Also, the child may require extra nutririon, which suggests that a supplement or an extra feeding can deliver more calories and vitamins to the child.
Physical limitations are necessary in children with Tetralogy of Fallot. While these restrictions may vary from one child to another, one should consult the physician if the child needs activity restriction, can participate in organized sports, or need a note to the child’s school or coach about the child’s exercise limitations.
Tet spells may happen in infants with unrepaired Tetralogy of Fallot and in line with this, it is important to reduce the child’s stress and anxiety to prevent them and to conserve the child’s energy. This can be done by picking him up slowly. Also, the child’s knees are brought up tight against his chest (knee-chest position) or have him squat down, to increase blood flow to the lungs.
Tetralogy of Fallot is a serious cardiopulmonary threat, so it is also important to contact 911 if the symptoms do not improve right away.