Tetralogy of Fallot must be repaired with open-heart surgery, either soon after birth or later in infancy. The timing depends on how severe your baby’s condition is.
Tetralogy of Fallot Treatment Options
Repairing the defects with surgery
Most children with this kind of heart defect have it repaired during a single surgery when they are very young. Sometimes more than one surgery is needed.
During surgery, the ventricular septal defect is closed with a patch, and the pulmonary stenosis is opened up.
Babies who have surgery usually do well. About 90 percent survive to adulthood and lead active lives.
If your newborn has tetralogy of Fallot and has severe cyanosis, your doctor may give the baby fluids through a vein (intravenously, or by IV) and medicines that help improve blood flow.
Managing tet spells
If your baby or child has Tet spells, your doctor will show you how to place the child in a knees-to-chest position. This position adjusts the pressure and blood flow in the heart. Older children usually squat spontaneously and do not have Tet spells.
Improving blood flow to the lungs
In babies who have arteries in their lungs that are too small to receive much blood, surgery may be needed first to increase blood flow to their lungs so their arteries will get bigger. Doctors do this by placing a shunt that directs more blood to the lungs. Later these children have a second surgery to correct the defects in their heart.
New Treatments for Tetralogy of Fallot
Later in life some children with tetralogy of Fallot need additional surgery to put in a new pulmonary valve. In the past, this required open-heart surgery. Now in some cases this can be done less invasively through cardiac catheterization or a hybrid procedure, using a device called the Melody transcatheter heart valve. This means a new pulmonary valve is placed through a narrow tube directed into your child’s heart. This avoids open-heart surgery and leads to quicker recovery. Our team at Seattle Children’s is participating in international studies to better understand which patients are best suited for these less invasive procedures.