TOF SURGERY IN INDIA
What is tetralogy of Fallot ?
Tetralogy of Fallot, also called TOF, is a congenital heart disease. A congenital heart disease is one that a person is born with. TOF is the most common heart disease that causes cyanosis (bluish color of the skin). Cyanosis occurs when blood from the right side of the heart goes directly to the left side. The blood does not pass through the lungs, and it will not carry enough oxygen to give to the body. Normally, veins bring blood from your child’s body to his heart. The blood from the body enters the right atrium first, then is pumped down into the right ventricle. The right ventricle then pumps the blood into the lungs where oxygen is added. The blood goes back to the heart into the left atrium and down into the left ventricle. The left ventricle then pumps the blood out to the body where the oxygen can be used.
With TOF, four different problems happen in your child’s heart while he is still inside the womb. The first problem is that the wall separating the two ventricles does not completely close, forming a hole. The second problem is that the blood vessel that connects the heart to the lungs is narrowed. The third problem is that the aorta (major artery) abnormally grows from both ventricles, rather than from the left ventricle only. The fourth problem is that the increased backflow of blood causes the muscles of the right ventricle to enlarge and thicken. These four defects may lead to decreased blood flow to the lungs and weakening of the heart. These problems may make it difficult for the heart and lungs to supply oxygen to your child’s body.
Types of Surgery in India
Complete Intracardiac Repair
Surgery to repair tetralogy of Fallot is done to improve blood flow to the lungs and to make sure that oxygen-rich and oxygen-poor blood flows to the right places.
The surgeon will : –
- Widen the narrowed pulmonary blood vessels. The pulmonary valve is widened or replaced and the passageway from the right ventricle to the pulmonary arteries is enlarged. These procedures improve blood flow to the lungs, allowing the blood to get enough oxygen to meet the body’s needs.
- Close the ventricular septal defect (VSD). A patch is used to cover the hole. This patch stops oxygen-rich and oxygen-poor blood from mixing between the ventricles.
Fixing these two defects resolves problems caused by the other two defects. When the right ventricle no longer has to work so hard to pump blood the lungs, it can return to a normal thickness. Fixing the VSD means that only oxygen-rich blood will flow out of the left ventricle into the aorta.
Symptoms Surgery in India
Infants with this condition usually have a heart murmur that can be heard at birth, or shortly there after. They have a bluish-purple color to the skin, a condition called cyanosis. The child is cyanotic because the blood circulating through the body does not have enough oxygen. Between the ages of 2 months and 2 years, children with Tetrology of Fallot may experience “blue” spells. These spells may be brought on by crying, straining to have a bowel movement, or fever.
A child who has tetrology of Fallot tends to develop slowly, eat poorly, and grow slowly. He or she may get short of breath, especially when exercising. A change in the shape of the fingertips, called clubbing, is another sign of this condition.
Diagnosis in India
After a complete history and physical exam are done, a variety of imaging tests can confirm the diagnosis.
- An electrocardiogram traces electrical activity in the heart muscle. It usually reveals enlargement in the muscles of the right ventricle of the heart, which pumps blood to the lungs.
- A chest X-ray shows a characteristic boot-shaped heart of fairly normal size.
- An echocardiogram uses sound waves to see a hole in the wall between the two sides of the heart. Narrowing of the pulmonary valve through which blood must pass on its way to the lungs can also been seen with this test.
Angiography provides detailed images of the structural defects in the heart and the degree to which blood flow is blocked. Angiography is an X-ray of the heart performed after a dye has been injected.
How Is Tetralogy of Fallot Treated ?
Tetralogy of Fallot must be repaired with open-heart surgery, either soon after birth or later in infancy. The goal of surgery is to repair the defects so the heart can work as normally as possible. Achieving this goal can greatly improve a child’s health and quality of life.
Your baby’s heart doctor and heart surgeon will determine when to do the surgery. Their decision will be based on the baby’s health and weight, how severe the defects are, and how severe the baby’s symptoms are.
Sometimes, teenagers or adults who had the tetralogy of Fallot defects repaired in childhood need additional surgery to correct heart problems that develop over time.