The Heart Center at Nationwide Children's is dedicated to the unique
needs of its patients. One of the conditions the center
supports is tetralogy of fallot. Tetralogy of fallot is a heart defect made up of
four heart problems. It results in cyanotic or blue babies. The four heart
problems are ventricular septal defect, overriding aorta, pulmonary stenosis and
right ventricular hypertrophy. A ventricular septal defect is a hole in
the wall between the two lower chambers of the heart called the ventricles. The
hole allows oxygen-rich blood to mix with oxygen-poor blood. Normally the
aorta attaches to the left ventricle which pumps oxygen-rich blood through it.
In an overriding aorta, the aorta has moved forward directly over the hole
between the ventricles. This allows oxygen poor blood from the right
ventricle to flow into the aorta. Pulmonary stenosis means that the blood
vessel going to the lungs called the pulmonary artery is narrowed and the
pulmonary valve doesn't open all the way. As a result less blood reaches the lungs.
These heart problems cause the baby to be blue because the heart pumps less
oxygen-rich blood to the body. Right ventricular hypertrophy means the wall
of the right ventricle is thicker than normal.
This happens because the right ventricle has to work harder to pump blood through
the narrowed pulmonary valve. Treatment for tetralogy of fallot may include
temporary and complete surgical repair procedures. Sometimes a child is not
ready for a complete repair right away. In this case a temporary repair called a
shunt can be placed until a complete repair can be done. The shunt improves
oxygen levels in the blood. During this procedure the surgeon will place a tube
called a shunt between a branch of the aorta and the right pulmonary artery. The
shunt will provide another path for blood to get to the lungs to pick up
oxygen. Instead of a shunt another temporary procedure can be done. In this
procedure a device called a stent is placed in the narrow area to allow more
blood to flow to the lungs. Most patients have a complete repair at four to six
months of age. If the main pulmonary artery is too small it will be widened
with a patch. If the pulmonary valve is too small it may be widened with a patch
called a transannular patch. If the narrowing is below the pulmonary valve
the surgeon will remove some of the heart muscle in this area. This improves
the flow of oxygen poor blood from the right ventricle to the lungs. To fix the
ventricular septal defect the surgeon will cover the hole with a
patch. The patch prevents the mixing of oxygen poor blood with oxygen-rich blood.
As a result only oxygen-rich blood flows out of the aorta to the body from the
left ventricle. The Heart Center team at Nationwide Children's is dedicated to
supporting your child. We are available to answer all of your questions at any
time at 614-722-2530 and at
Nationwidechildrens.org/Heart.