Tetralogy of Fallot Repair

What is Tetralogy of Fallot Repair

Tetralogy of Fallot (TOF) repair is an open-heart surgery. It is done to correct a specific four-part congenital heart defect so that blood can reach the lungs properly and carry enough oxygen to the body.

When is it performed?

It is usually performed between 3 and 6 months of age. However, it can also be performed later, including in adulthood, if not repaired earlier.

Best heart surgeons in Mumbai try to repair the heart while keeping the pulmonary valve (the heart valve that helps manage blood flow in the heart) intact. This leads to better long-term outcomes.

Tetralogy of Fallot (TOF) repair is also known as:

1. TOF repair
2. Corrective repair of tetralogy of Fallot.

What is Tetralogy of Fallot?

It is a heart defect present at birth. TOF consists of 4 different heart abnormalities that disturb the normal flow from the heart and lungs.

1. A Ventricular Septal Defect

A hole between both ventricles (the two lower chambers of the heart) in the heart.

2. Overriding Aorta

The aorta (the major blood vessel in the heart) is in the wrong place.

3. Pulmonary Stenosis

Narrowing of the artery that carries blood to the lungs.

4. Right Ventricular Hypertrophy

It is the thickening of the heart's lower right chamber because of pressure overload.

TOF repair is a one-heart surgery that corrects all four defects in one operation.

Tetralogy of Fallot Repair Procedures

Repair options may vary based on your child’s condition.

1. Complete Repair

• The best heart surgeon in Mumbai can make the pulmonary valve and the path to the pulmonary artery wider.
• And they can patch the hole between the two ventricles.

2. BTT Shunt Procedure

• The doctor can place a shunt or tube between the child’s subclavian and pulmonary arteries
• This helps better blood flow to the lungs.

3. Catheter Procedure

• They can place a stent for better blood flow out of the right ventricle.
• The experts can also insert a stent in the patent ductus arteriosus for proper blood flow.

Tetralogy of Fallot Repair Steps

The step may vary. Here are the general steps:

1. Right Ventricle Incision

Doctor make a small opening in the right lower chamber of the heart.

2. Infundibular Resection

The blockage is cleared.

3. VSD Closure

The hole between the two lower chambers is closed with a patch, such as a Dacron or pericardial patch.

4. RVOT Reconstruction

The path to the lungs is widened.

5. De-airing and Closure

Air bubbles from the heart are removed, it is restarted, and it is monitored with ultrasound.

What are the Risks Associated With Tetralogy of Fallot Repair

Early complete TOF repair can be accomplished with a low mortality. However, there are certain risks that the doctor will help prevent with the right treatment.

• Higher risk of an infection in the heart (antibiotics may be prescribed).
• A child may show slower development and growth (they may need physical, speech, or occupational therapy, etc.).
• Higher pregnancy risks (you need to check your heart before getting pregnant).

What Is the Success Rate of TOF Surgery in India?

Infant repairs (3-6 months) yield >97% survival. It has been seen that twenty-five–year survival following TOF repair was 94.5%.

Who is the Right Candidate?

It is recommended for newborns, infants, and children diagnosed with Tetralogy of Fallot.

Who May Not be The Right Candidate?

A patient with the following condition may not be the right candidate:

• Severe comorbidities.
• Uncontrolled infections.
• Where risks of surgery outweigh the potential benefits.

Cost of TOF Repair in Mumbai

The cost depends on the complexity of the cases, the type of hospital, the location, the surgeon's expertise, the duration of stay, or any other individual factors.

The cost may range between ₹400,000 and ₹650,000 (USD 4,800–7,800)