Tetralogy Of Fallot (TOF) is a heart condition that babies are born with, affecting around 4 out of every 10,000 births. Some babies might not show signs at birth, while others may have severe symptoms. As they grow, infants with TOF often experience episodes where their skin turns blue due to lack of oxygen in their blood, a condition called cyanosis.

Parents and caregivers must recognize these symptoms early to seek medical help promptly. Detecting TOF sooner allows doctors to intervene and provide the necessary care for better outcomes. 

With advancements in medical technology and surgical techniques, treatments for TOF have become highly effective, with success rates reaching up to 99%. This means most babies undergoing TOF surgery can lead healthy lives without significant complications. 

What Is Tetralogy of Fallot?

Tetralogy Of Fallot (TOF) is a heart condition in which a baby is born with four abnormalities in how their heart develops. These issues make it hard for the baby’s heart to send enough oxygen to its entire body.

Usually, your blood travels a specific route through your heart with every heartbeat. Due to the structural abnormalities in a heart with TOF, some blood that doesn’t have oxygen can go into the aorta and out to the body instead of to the pulmonary artery to get oxygen.

Four abnormalities of TOF

People who have tetralogy of Fallot usually have these four issues:

• The wall separating your left and right ventricles has a hole (ventricular septal defect), letting blood without oxygen combine with oxygen.
• Your pulmonary valve and main pulmonary artery aren’t wide enough, so there isn’t enough blood getting through to your lungs with each heartbeat.
• The aorta and its valve are shifted over. Instead of only being above the left ventricle, they’re above and open to both ventricles because the wall between them isn’t complete. This allows blood that’s supposed to go to your pulmonary artery (to get oxygen from your lungs) to go to your aorta. Instead of going to get oxygen, that blood goes out to your body.
• The muscle wall around your right ventricle is too thick (ventricular hypertrophy) because it works harder than it should to compensate for the heart’s other abnormalities.

Dr. Dinesh Kumar Mittal is a renowned cardiac surgeon specializing in treating Tetralogy of Fallot (TOF). With years of experience and expertise, Dr. Mittal has successfully performed numerous TOF repair surgeries, providing hope and improved quality of life to patients born with this congenital heart defect. His dedication to excellence and compassionate care make him a trusted figure in pediatric cardiology.

What Are Its Symptoms?

The symptoms can be mild, moderate, or severe. They usually get worse over time without treatment.

Tet spells

Babies who haven’t gotten treatment for tetralogy of Fallot can get “tet spells” when their oxygen level drops without warning while or after feeding, crying, or pooping. Tet spells can be as short as a few minutes to as long as several hours. Your baby may sleep a lot after a tet spell.

Signs of a tet spell include:

• Having very blue skin (cyanosis)
• Having a limp body
• Feeling very tired
• Being restless
• Not responding to parents
• Losing consciousness
• Having a hard time breathing 
• Having convulsions
• Being unable to move one side of their body for a short time

Other symptoms and signs include:

• Fainting
• A heart murmur you can hear through a stethoscope
• Seizures
• Not much desire to eat
• Dizziness
• Gaining weight slowly

Tetralogy of Fallot symptoms in adults:

• Skin with a bluish tint
• Inability to exercise because of a lack of oxygen
• Fainting
• Chest pain
• Heart palpitations

What Causes Tetralogy Of Fallot?

Healthcare providers don’t know what exactly causes this abnormality. However, possible causes include:

• A parent who’s had a heart abnormality since birth doesn’t usually pass it to their child. However, the risk may be higher if both parents have a heart issue
• Having rubella or diabetes, drinking alcohol, or eating a poor diet while pregnant can put the fetus at a higher risk of a congenital heart problem
• Being pregnant after age 40 may be a risk factor
• A rare condition called phenylketonuria (a buildup of an amino acid) can increase your child’s risk of a heart issue

“This CHD can be prevented with comprehensive prenatal care,” Dr. Mittal states. “Mothers can do it by avoiding known risk factors like maternal infections such as rubella, uncontrolled diabetes, and exposure to harmful substances like alcohol. Maintaining a healthy lifestyle, including a balanced diet and regular exercise, promotes overall maternal and fetal well-being, reducing the likelihood of congenital heart defects like TOF.”

“Dr. Mittal’s expertise and care transformed our daughter’s life. His skillful surgery for TOF repaired her heart, and now she’s thriving like never before. We’re forever grateful to Dr. Mittal and his team for their dedication and compassion.” – The Smith Family.

“Our son’s journey with TOF was daunting, but Dr. Mittal’s confidence and competence put us at ease. His meticulous approach to surgery and post-operative care ensured a smooth recovery. Today, our son is a happy, healthy child, all thanks to Dr. Mittal’s exceptional care. We can’t thank him enough for giving our family hope and happiness.” – The Johnson Family.

What Is The Cost Of Treating Tetralogy Of Fallot In India?

Treating Tetralogy Of Fallot (TOF) in India can range from INR 3,00,000 to 8,00,000 (approximately $4,000 to $10,000) for surgical repair. However, this can significantly differ based on individual patient requirements, hospital amenities, and geographical location.

Factors affecting cost:

• Hospital choice: Costs may vary depending on the hospital’s reputation and facilities.
• Surgeon’s fees: Experienced surgeons may charge higher fees for their services.
• Diagnostic tests: Pre-operative tests such as echocardiograms and blood tests contribute to the overall cost.
• Length of hospital stay: Longer hospital stays increase room, board, and nursing care expenses.
• Post-operative care: Medications, follow-up visits, and rehabilitation also impact the total expenditure.

Conclusion

TOF presents significant challenges for affected infants, but early detection and prompt medical intervention can significantly improve outcomes. With advancements in medical technology and surgical techniques, treatments for TOF have become highly effective. Recognizing the symptoms of TOF, such as cyanosis and tet spells, is crucial for timely medical attention and management. While the exact cause of TOF remains unknown, awareness of potential risk factors during pregnancy can help mitigate the chances of congenital heart problems.

FAQs 

Q: Can Tetralogy of Fallot be detected before birth?

A: Yes, TOF can be diagnosed prenatally through fetal echocardiography.

Q: Is TOF a curable condition?

A: While TOF is not curable, it is treatable through surgical interventions to improve heart function and quality of life.

Q: Can adults with TOF lead normal lives?

A: With proper medical care and monitoring, many adults with TOF can lead fulfilling lives, though they may need ongoing cardiac follow-up.

Q: Are there any long-term complications associated with TOF repair surgery?

A: While TOF repair surgery is highly successful, some individuals may experience long-term issues, such as arrhythmias or pulmonary valve problems, that require ongoing management.

Q: Can TOF be inherited?

A: While most cases of TOF are sporadic, meaning they occur randomly, there is a slightly increased risk of recurrence in families with a history of congenital heart defects.

Read More : Is Fontan Surgery the Right Choice for My Child’s Heart Condition?