Tetralogy of Fallot (TOF) repair
Tetralogy of Fallot (TOF) repair is a surgical procedure in which the pulmonary blood vessels are broaden which were narrowed.
Some facts about Tetralogy of Fallot (TOF) repair:
Tetralogy of Fallot or TOF is a cardiac abnormality which is a combination of four heart defects that come altogether.
The four defects are :
- VSD is a hole between the left and right ventricles of the heart.
- Right Ventricular Hypertrophy causes the thickening of the muscular walls of the right ventricle, since the right ventricle pumps the blood at high pressure.
- Overriding Aorta is an enlargement of the aortic valve which appears to emerge both from left and right ventricles. rather than originating from left ventricle normally.
- Pulmonary Stenosis is a condition in which the pulmonary tract and the outflow tract i.e. the portion beneath the valve narrows up causing the blockage of blood circulation from right ventricle to pulmonary artery.
Corrective surgery is required for all babies who have tetralogy of Fallot.
Preparation for Tetralogy of Fallot (TOF) repair:
- Oxygen level measurement (pulse oximetry), Echocardiogram, Electrocardiogram (ECG or EKG), Chest X-ray and Cardiac catheterization are usually done before the surgery to evaluate the structure of the heart and plan surgical treatment.
- The most appropriate surgery and the timing of the surgery will be determined based on your or your child's condition.
- Medicine is required for some children while waiting for surgery to maintain blood flow from the heart to the lungs.
Procedure for Tetralogy of Fallot (TOF) repair:
Open-heart surgery or a temporary procedure that uses a shunt is required to correct the defects (intracardiac repair).
Intracardiac repair:
Intracardiac repair is an open-heart surgery that is usually done during the first year after birth and involves several repairs.
This procedure is usually not preferable for adults with tetralogy of Fallot if they didn't have surgical repair as children.
The ventricular septal defect will be patched by the surgeon to close the hole between the lower chambers of the heart (ventricles) during intracardiac repair.
The narrowed pulmonary valve will be either repaired or replaced to increase blood flow to the lungs
The right ventricle wall will go back to its normal thickness as the right ventricle won't need to work as hard to pump blood after this procedure.
The oxygen level in the blood increases and symptoms decrease after intracardiac repair.
Temporary shunt surgery:
A temporary (palliative) surgery is sometimes required before having intracardiac repair in order to improve blood flow to the lungs.
This procedure may be done has pulmonary arteries that are undeveloped (hypoplastic) or if your baby was born prematurely.
A bypass (shunt) between a large artery will be created by the surgeon during this procedure that branches off from the aorta and the pulmonary artery
The shunt will be removed during the procedure for intracardiac repair when your baby is ready for intracardiac repair.
Although, the long-term survival rates of tetralogy of Fallot surgery continue to improve, sometimes blood flow to the lungs may still be restricted after tetralogy of Fallot surgery.
Additional surgeries may be needed in these cases.
The pulmonary valve may be replaced if an adult with repaired tetralogy of Fallot have a leaky pulmonary valve (pulmonary valve regurgitation).
