What is Tetralogy of Fallot or TOF? This congenital disease is a heart defect that causes four problems. They are: 1. A hole between the lower chambers of the heart (VSD) 2. Narrowing of the path from the heart to the lungs 3. The aorta artery (oxygenated blood vessel of the heart) is located on the opening of the hole between the lower chambers of the heart. 4. The muscle of the right lower chamber of the heart becomes too thick.

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- Know valve and pulmonary artery stenosis in children. - How dangerous is the hole in the heart of children VSD?

Essential information for parents with a child with TOF tetralogy of Fallot. ### What is the cause? In most children, the cause of TOF tetralogy of Fallot is unknown. This disease is a common type of congenital heart defect. It may be more common in children with Down syndrome or D-George syndrome. Some children can have other heart defects with TOF tetralogy of Fallot. ### What effect does it have on the heart? Normally, the left side of the heart only pumps blood to the body and the right side of the heart only pumps blood to the lungs. In a child with TOF tetralogy of Fallot, blood can be present through the hole (VSD). It goes from the right blood pumping cavity (right ventricle) to the left blood pumping cavity (left ventricle). From this path, it is transferred into the aorta artery (the main blood vessel full of oxygen). A narrowing of the pulmonary artery that leads from the right ventricle to the pulmonary artery prevents the normal amount of blood from being pumped to the lungs. Sometimes the pulmonary valve is completely blocked (pulmonary atresia). ### How does TOF tetralogy of Fallot affect my child? Infants and young children with unrepaired TOF tetralogy of Fallot often have blue skin (cyanosis). The reason is that some of the deoxygenated blood is transported to the lungs instead. It is transferred to the arterial blood stream of the whole body through the hole in the wall between the right and left ventricles. Related article of cardiac cyanosis in children What are the types of heart disease in children?

How is TOF tetralogy of Fallot diagnosed? Tetralogy of Fallot TOF is a congenital disease. who is with the patient since the birth of the baby. Often, in the initial examinations of babies, they suspect this heart disease by hearing abnormal heart sounds, but the main method of diagnosing the disease is echocardiography of the baby's heart. Related article: How is children's heart echo performed?

What can be done about TOF tetralogy of Fallot? Tetralogy of Fallot TOF is treated with surgery. If the child is small or there are other problems, a temporary operation may be performed at first. Full repair will be done later. Sometimes the first operation is a complete restoration. ### Primary temporary action: In some babies, it is possible. First, a shunt operation should be performed to provide sufficient blood flow in the lungs. This is not open heart surgery and does not repair the inside of the heart. A shunt is usually a small tube of synthetic material that is sewn between the aorta and pulmonary artery. When the complete repair is later done, the shunt is closed. ### Full restoration: Full restoration is done early in life. By removing some thickened muscle under the pulmonary valve, repairing or removing the narrow pulmonary valve and, if necessary, enlarging the pulmonary arterial branches that go to each lung, the surgeon closes the ventricular wall defect with a patch and opens the right ventricular outflow tract. Sometimes a tube is placed between the right ventricle and the pulmonary artery. This is sometimes called Rastli restoration. This is similar to the type of repair used in some other heart defects.

Tetralogy of Fallot is treatable.

Will my child's activities be limited? If there is a blockage or leak in the pulmonary valve, which is common after repair, your child may need to limit physical activity, especially for competitive sports. Children with reduced heart function or rhythm disorders may need to limit their activity more. If the tetralogy has been surgically repaired, and there is no blockage or leak in the pulmonary valve, your child may be able to participate in normal activities without much increased risk. Your child's cardiologist will help you decide whether your child needs to limit physical activity. Related article Is the PFO hole in the baby's heart dangerous?

What will my child need in the future? If your child has had surgery to repair TOF tetralogy of Fallot, he or she will need regular follow-up with a pediatric cardiologist. As an adult, your child will need regular lifelong follow-up with a cardiologist who has had special training in congenital heart defects. Some long-term problems can include residual obstruction or worsening stenosis between the right heart pumping chamber and the pulmonary veins. Children with TOF have a higher risk of heart rhythm disorders called arrhythmias. Sometimes this problem may cause dizziness or fainting. Overall, the long-term outlook is good. But some children may need medication, cardiac catheterization, or even reoperation.

What should be done about the prevention of endocarditis? Children with TOF are at increased risk for endocarditis (heart infection). Some children, including those who have had valve replacements, still have shunts or leaks around surgical sites and need antibiotics before certain dental procedures to prevent endocarditis. To know more, use the links below.

https://fa.m.wikipedia.org/wiki/Tetralogy of Fallot https://www.cdc.gov/ncbddd/heartdefects/atrialseptaldefect.html https://www.heart.org/en/health-topics/congenital-heart-defects/about-congenital-heart-defects/tetralogy-of-fallot