Tetralogy of Fallot (TOF)

Tetralogy of Fallot (TOF) is a congenital heart defect that is present at birth.
Classically there are four defects:

  • A ventricular septal defect (a hole between the two ventricles)
  • Pulmonary stenosis, narrowing of the pulmonary valve (pulmonary valvular stenosis)
  • Right ventricular hypertrophy (enlargement of the right ventricle)
  • An overriding aorta, which allows blood from both ventricles to enter the aorta

Symptoms :

1. Episodes of bluish color to the skin.They may develop a “tet spell” where they turn very blue, have difficulty breathing, become limp, and occasionally lose consciousness.
2.  Heart murmur, finger clubbing, and easy tiring during breastfeeding.
Prevalence: TOF occurs in 5%-10 % in all congenital heart diseases.

Treatment:
TOF is typically treated by open heart surgery in the first year of life.
Palliative surgery : Modified Blalock- Taussig (BT) shunt

Definitive surgery :

Ventricular septal defect (VSD) patch closure and pulmonary valvuloplasty.

Timing of surgery depends on the baby’s symptoms and size. The procedure involves increasing the size of the pulmonary valve and pulmonary arteries and repairing the ventricular septal defect. In babies who are too small a temporary surgery may be done with plans for a second surgery when the baby is bigger.