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Tetralogy of Fallot (TOF) is a complex congenital heart disorder that comprises four distinct heart defects. These defects combine to cause insufficient oxygenation of the blood, often leading to cyanosis or a bluish discolouration of the skin. The contributing defects include a ventricular septal defect (VSD), pulmonary stenosis, right ventricular hypertrophy, and overriding aorta. Causes of this condition can be attributed to genetic factors, environmental influences during pregnancy, or a combination of both.
In Chennai, the prevalence of congenital heart defects like TOF has been noted, with several individuals seeking medical attention. Apollo Hospitals Chennai boasts some of the best doctors or cardiologists and surgeons for tetralogy of Fallot treatment who utilise advanced medical technology and superior healthcare practices to deliver effective care to patients.
The anatomical abnormalities in TOF present in four forms:
Ventricular Septal Defect (VSD): This is characterised by an opening between the two lower chambers of the heart.
Pulmonary Stenosis: This involves narrowing down the pulmonary valve or right ventricular outflow tract, leading to reduced lung blood flow.
Overriding Aorta: In this state, the aorta is shifted towards the right, accepting blood from both ventricles.
Right Ventricular Hypertrophy: This denotes a thickening of the muscle wall of the right ventricle.
Individuals diagnosed with TOF typically exhibit symptoms such as:
Cyanosis (a bluish tint to skin, lips, and fingernails due to lowered oxygen levels in blood)
Unusual sound heard from the heart via a stethoscope
Difficulty feeding that leads to below-par weight gain in infants
Clubbing of fingertips or toes
Shortness of Breath
To confirm a diagnosis of TOF, the following tests can be recommended by doctors for the treatment of tetralogy of Fallot or tetralogy of Fallot surgeons:
Echocardiogram (Echo): Provides detailed images of the heart to visualise VSD, pulmonary stenosis, overriding aorta, and right ventricular hypertrophy.
Electrocardiogram (ECG or EKG): Records heart's electrical activity, revealing signs of right ventricular hypertrophy common in TOF.
Chest X-ray: Offers an overview of heart size and lung blood flow patterns, showing characteristic 'boot-shaped' heart.
Cardiac Catheterization: Invasive procedure measuring pressures and blood flows within heart chambers and vessels, confirming TOF diagnosis and assessing severity.
MRI (Magnetic Resonance Imaging): Provides detailed imaging of the heart and great vessels, useful when echocardiography results are inconclusive or more information is needed.
At Apollo Hospitals Chennai, various treatment and surgical options for TOF are available. These include:
Initial Stabilisation: This includes administering Prostaglandin E1 (PGE1) to keep the ductus arteriosus open and improve oxygenation, along with β-Blockers to manage cyanotic spells.
Surgical Interventions: This includes complete repair, mostly performed during infancy, that involves closing the VSD and widening the pulmonary valve and outflow tract. In some instances, surgeons for tetralogy of Fallot correction recommend a temporary procedure such as a Blalock-Taussig shunt until the child is ready for a complete repair.
Post-Surgery Care: Regular follow-ups with the doctors treating tetralogy of Fallot as well as medication management and lifestyle modifications are needed.
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