Tetralogy of Fallot

---

Tetralogy of Fallot is a common heart defect with four components:

• A large ventricular septal defect or VSD (opening between the lower two chambers of the heart);
• Pulmonary valve stenosis; 
• Right ventricular hypertrophy (muscle thickening), and;
• An overriding aorta (straddling over both the left and right ventricles). 

These children can have cyanotic spells (“Tet spell”) in which are there is cyanosis (blue coloring of the skin, nails and lips due to low oxygen levels).  In some small babies or those with other problems, the child may have palliation with a shunt or a synthetic tube placed between the artery to the right arm and the artery to the right lung (modified Blalock-Taussig Shunt).  These children would then undergo later correction. However in most cases, it is preferred to totally repair the child’s Tetralogy of Fallot by the time they are 4 to 6 months of age, or sooner if necessary.

Surgical correction:  Consists of closure of the ventricular septal defect (VSD) using a Dacron patch so that the aorta is connected to left ventricle and opening of the pulmonary valve.  Usually the surgeon tries to open the pulmonary valve and cut out thickened muscle below the pulmonary valve to relieve any pulmonary stenosis.  Sometimes a patch of natural material or donor material is needed to accomplish this.  In severe pulmonary stenosis or even pulmonary valve atresia (total blockage), a valve from a donor must be inserted to accomplish repair.