Tetralogy of Fallot – ToF

We’re now getting to a more complicated condition called the Tetralogy of Fallot – or ToF, for short. The diseases discussed until now had just one abnormality in the heart – Atrial Septal Defect (ASD) or Ventricular Septal Defect (VSD) or Patent Ductus Arteriosus (PDA).

As the name tetralogy implies, there are FOUR abnormalities combined together in this complex heart defect. ToF is also commonly called the “blue-baby” disease.

In this article, you’ll learn:

  • What are the components of ToF?
  • Why is it called “Blue Baby Disease”?
  • What exactly happens in ToF?
  • What is a “cyanotic spell”?
  • What happens if ToF is left uncorrected?
  • What are the surgical options?
  • How is a single stage intra-cardiac repair done?
  • Variations in ToF needing modified repair
  • What is an “outflow patch”?
  • When is an intracardiac repair NOT possible?
  • What are the palliative operations for ToF?
  • The Blalock-Taussig shunt
  • Other systemic-pulmonary shunt procedures
  • What is the outcome after a total correction operation?
  • What is the future course after a shunt procedure?

Basics of Tetralogy of Fallot

What are the four components of ToF ?

1. The first is a Ventricular Septal Defect – or VSD.

2. Next is a narrowing of the Pulmonary Valve, which guards the junction of the right ventricle with the pulmonary artery. This narrowing is called Pulmonary Stenosis (PS).

3. The third feature is a thickening of the wall of the right ventricle (RV). This increases the strength of the right ventricle and helps it pump blood more forcibly. This thickening is called RV Hypertrophy.

4. And the last component is an over-riding aorta.

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