What is the treatment of Tetralogy of Fallot

What is the treatment of Tetralogy of Fallot?

What is the treatment of Tetralogy of Fallot?

Tetralogy of Fallot requires surgical intervention, typically performed through open-heart surgery, either shortly after birth or later in infancy. The primary objective of the surgery is to address the four defects associated with Tetralogy of Fallot, aiming to restore the heart’s function as much as possible. Repairing these defects can significantly enhance a child’s health and overall quality of life.

The timing of the surgery is determined by a team of pediatric cardiologists and cardiac surgeons, who evaluate factors such as the baby’s health, weight, the severity of the defects, and the symptoms experienced by the baby. This decision is made to ensure the best possible outcome for the child.

In some cases, teenagers or adults who underwent Tetralogy of Fallot repair during childhood may require additional surgery later in life to address heart problems that may develop over time.

What is the treatment of Tetralogy of Fallot?

Types of Surgery

Complete Intracardiac Repair

Surgery for repairing Tetralogy of Fallot aims to enhance blood flow to the lungs and ensure proper circulation of oxygen-rich and oxygen-poor blood. During the procedure, the surgeon will:

  • Expand narrowed pulmonary blood vessels: The pulmonary valve may be widened or replaced, and the passage from the right ventricle to the pulmonary artery is enlarged. These adjustments facilitate improved blood flow to the lungs, ensuring adequate oxygenation to meet the body’s demands.
  • Close the ventricular septal defect (VSD): A patch is utilized to cover the hole in the septum, preventing the mixing of oxygen-rich and oxygen-poor blood between the ventricles.

Addressing these two defects rectifies issues caused by the other two defects. With reduced strain on the right ventricle to pump blood to the lungs, it can return to its normal thickness. Closing the VSD ensures that only oxygen-rich blood flows from the left ventricle into the aorta.

The incision made by the surgeon to access the heart typically heals within approximately 6 weeks. Guidance regarding when it’s safe to bathe the baby, lift them under the arms, and schedule regular immunizations will be provided by the surgeon or hospital staff.

Temporary or Palliative Surgery

In the past, it was common to perform temporary surgery during infancy for babies with Tetralogy of Fallot. This interim procedure aimed to enhance blood flow to the lungs. A complete repair of the four defects was typically conducted later in childhood.

Today, most babies diagnosed with Tetralogy of Fallot undergo full defect repair during infancy. However, some infants may be too weak or small to undergo the complete repair initially. In such cases, temporary surgery becomes necessary. This temporary intervention serves to improve oxygen levels in the blood and allows the baby time to grow and strengthen before undergoing the full repair.

During the temporary surgery, the surgeon inserts a tube called a shunt between a large artery branching off the aorta and the pulmonary artery. One end of the shunt is attached to the artery branching off the aorta, while the other end is connected to the pulmonary artery. This shunt establishes an alternate pathway for blood to reach the lungs and receive oxygen. The shunt is removed when the baby undergoes the full repair to correct the heart defects.

Following temporary surgery, your baby may require medications to maintain the shunt’s openness while awaiting the full repair. These medications are typically discontinued after the shunt is removed.