Tetralogy of Fallot, T.O.F as it popularly called is a combination of 4 anomaly that a child is born with. They are Ventricular Septal Defect, Pulmonary Stenosis, Right Ventricular Hypertrophy, Overiding Aorta. TOF is characterized by the low oxygen saturation and sometimes Tet spells. Surgery is advised in the first year for a great outcome. TOF may require palliate surgery before the definitive one. It sometimes may be associated with Down Syndrome.
Signs and Symptoms
- Low oxygen saturation (SpO2)
- Mild to profound cyanosis
- Heart murmur
- Failure to gain weight
- Laboured breathing
- Retarded growth
- Polycythemia
- Squaring during sleeps
- Blue lips and extremeties
Diagnosis/investigation
- Chest X-ray
- Pulse oximetry
- Echocardiography
- Electrocardiogram
- Cardiac catheterization
Surgery
Children with TOF typically undergo surgery between three and six months of age. For most, a full repair surgery is performed as the initial operation. Less commonly, children require a staged approach with the initial operation being a Blalock-Taussig (BT) shunt. A BT shunt is a tube placed between the body artery and the lung artery to increase blood flow to the lungs.
Full surgical repair of TOF requires closing the ventricular septal defect (VSD) between the right and left ventricles and relieving the narrowing between the right ventricle and pulmonary artery