Tetralogy of Fallot Treatment in Nigeria by Indian Cardiac Surgeon

How is the tetralogy of Fallot disorder classified?

The Tetralogy of Fallot is a coronary heart disorder that is characterized by four abnormalities. Let us see them in detail: 

1.  A ventricular septal defect is a hollow inside the wall that splits the left and proper ventricles. This affects in allowing oxygenated and deoxygenated blood to mix. 
2. The pulmonary artery and valve aren’t large sufficient. Therefore the blood does no longer pump sufficiently to the lungs each time the coronary heart beats. 
3.  The aorta and its valve are moved to the opposite side. Primarily they are positioned above the left ventricle. But on this ailment, they’re open to both ventricles as the wall between the ventricles is incomplete. Due to this, the blood travels to the aorta in place of the pulmonary artery. (in which it receives oxygen from the lungs)
4. Lastly, there may be ventricular hypertrophy. Here the wall across the right ventricle thickens as it makes extra efforts to make up for the opposite heart abnormalities.

What are the Symptoms of Tetralogy of Fallot?

Symptoms of Tetralogy of Fallot can vary. These signs tend to worsen over time without intervention. Here are some key indications you must pay attention to:

 Tet Spells Signs:

• Sudden drops in oxygen levels during or after crying, feeding, or bowel movements.
• Duration can vary from a few minutes to several hours.
• Observable signs include very blue skin (cyanosis – the blood does not carry enough oxygen), lethargy, restlessness, unresponsiveness, loss of consciousness, difficulty breathing, and potential convulsions.

Other Symptoms and Signs:

• Fainting episodes.
• Audible heart murmur with a stethoscope.
• Seizures.
• Reduced appetite.
• Dizziness.
• Slow weight gain.

Symptoms in Adults:

• Bluish tint to the skin.
• Exercise intolerance due to oxygen deficiency.
• Fainting.
• Chest pain.
• Heart palpitations (flip-flopping of heartbeats).

What are the causes of Tetralogy of Fallot?

 Understanding the origins of heart defects, including tetralogy of Fallot, remains elusive in many cases.

 However, several factors come into play, contributing to the development of these conditions. Let’s delve into the complexities:

How is tetralogy of Fallot diagnosed?

During pregnancy, your healthcare provider may detect potential signs of Tetralogy of Fallot in ultrasound images. 

Between 18 to 22 weeks, a fetal echocardiogram assesses the heart’s structure. This painless test helps determine if the heart is developing normally.

• Tests in Infancy: If Tetralogy of Fallot is suspected in your newborn, your provider may identify a heart murmur. A painless pulse oximetry test measures oxygen levels, and if low, an echocardiogram visualizes the heart structure. Sensors on your baby’s feet or hands help with pulse oximetry.
• Pulse Oximetry: Measures oxygen levels in your newborn’s blood.
• Echocardiogram: Uses sound waves to assess heart structure and function.
• Chest X-ray or CT Scan: Reveals the unique boot-shaped abnormality in the heart.
• Tests in Childhood or Adulthood: Diagnosing Tetralogy of Fallot in older individuals involves the same methods used in infancy, along with additional assessments.
• Electrocardiogram (EKG): Records the heart’s electrical activity.
• Cardiac Catheterization: Invasive procedure to gather detailed information about the heart’s condition.

These diagnostic measures, ranging from simple pulse oximetry to advanced imaging techniques, allow healthcare providers to identify and understand the Tetralogy of Fallot at different stages of life, facilitating appropriate management and care.

How is the Tetralogy of Fallot treated? 

In the absence of tetralogy of Fallot surgery, symptoms tend to worsen over time. 

Shortly after birth, surgical intervention becomes a crucial step to redirect blood flow through the heart correctly. 

A cardiac surgeon needs to perform remedial surgery on every infant diagnosed with tetralogy of Fallot. If therapy is not provided, the child may not reach its full developmental potential. Depending on the parent or child’s condition, the doctor will select the most suitable procedure and timing for it. 

During the waiting period for surgery, certain children might require medication to ensure proper blood flow between the heart and lungs. 

What Complications Can Arise from Tetralogy of Fallot Surgery?

 In cases where the pulmonary valve is compromised, your child might require a valve replacement procedure. This step becomes crucial for maintaining optimal heart function and addressing any issues arising from valve dysfunction.

If the pulmonary valve is functioning well post-surgery, your child may resume normal activities without restrictions. However, if complications arise adjustments may be needed.

After tetralogy of Fallot surgery, there is an increased risk of abnormal heart rhythms. Regular monitoring and appropriate medical management may be necessary to address and mitigate these potential complications.

Understanding these post-surgery challenges allows healthcare providers to implement timely interventions ensuring the best possible outcomes for those who have undergone tetralogy of Fallot surgery.

What is the recovery period after Tetralogy of Fallot treatment?

The recovery period following surgery for Tetralogy of Fallot typically spans several months. 

The incision made during the procedure requires approximately six to eight weeks for complete healing. In cases where the infant’s size limits a full repair, a temporary intervention might be performed, with a subsequent surgery planned for full defect correction after a few years.

Post-surgery, special attention is crucial while feeding the infant. Additional nutrition may be needed, and consulting the doctor for guidance on the feeding routine is advisable. Ideally, the baby should be fed frequently to support a smooth recovery process.

What Is the Life Expectancy for Tetralogy of Fallot Patients? 

Without intervention, approximately half of individuals with untreated Tetralogy of Fallot may not survive beyond the age of 6. 

However, with the advancements in surgical procedures, those who undergo corrective surgery typically experience a favorable prognosis. 

It’s important to note that many patients may require additional medical care, monitoring, and curative surgeries later in life. 

What is the success rate of tetralogy of Fallot surgery?

Achieving a 94% survival rate heart surgeons exhibit exceptional success in repairing the Tetralogy of Fallot through surgery. This complex condition necessitates surgical intervention addressing the four distinctive flaws it comprises.

During the surgical procedure for Tetralogy of Fallot, the pulmonary blood arteries undergo expansion either through widening or complete replacement. Surgeons may also widen or extend the tube connecting the right ventricle to the pulmonary artery, thereby optimizing blood flow to the lungs.

In addition to these measures, surgeons employ a patch to effectively close the ventricular septal defect ensuring that oxygenated and deoxygenated blood no longer mix. 

By addressing these fundamental issues, the associated challenges posed by the other two heart defects in the Tetralogy of Fallot are resolved. 

This comprehensive approach allows the right ventricle to function optimally, reducing the need for rapid pumping to maintain a healthy blood flow.

What is the cost of tetralogy of Fallot (TOF) surgery in India?

Addressing Tetralogy of Fallot (TOF) requires the expertise of a highly skilled cardiac surgeon due to its rarity and complexity.

Given the presence of four distinct problem areas in this congenital condition, the surgical procedure typically spans four to five hours. 

The intricacy of the treatment process, coupled with the delicate nature of the ailment contributes to the higher cost of TOF surgery in India compared to many other cardiology procedures. 

Surgeons navigate through each problem, addressing the defects in a step-by-step manner.

The estimated cost of TOF surgery in India is around 5,38,955 INR i.e. $6500, a significantly lower figure compared to the United States, where the same surgery is estimated to cost around 41,45,375 INR i.e. $50000. 

This cost differential highlights the accessibility of quality medical care for TOF in India at a fraction of the expense incurred in some other countries.

Conclusion

With active prenatal care and vigilant monitoring, tetralogy of Fallot can safely guide pregnancy to term. It is essential for those considering pregnancy to consult with both an adult congenital heart disease specialist and an obstetrician experienced in managing special medical conditions.

While surgical interventions effectively address the physical aspects of tetralogy of Fallot, ongoing care is crucial.  

For parents or caregivers feeling overwhelmed with emotional concerns related to surgical scars or developmental comparisons seeking support from a therapist is encouraged. 

Expert guidance from MedicoExpert ensures a comprehensive approach to the medical aspects of tetralogy of Fallot care. MedicoExpert places a strong emphasis on providing support and counseling services. 

With an expert team, including congenital heart specialists and obstetricians we offer tailored solutions associated with this congenital heart condition.

Book an appointment today!