Tetralogy of Fallot (TOF) treatment in 149 Cardiac surgery clinics in Americas

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149 clinics specializing in Cardiac surgery providing treatment of Tetralogy of Fallot (TOF) Tetralogy of Fallot (TOF) is a congenital heart defect characterized by four abnormalities: ventricular septal defect, pulmonary stenosis, overriding aorta, and right ventricular hypertrophy. It causes cyanosis and requires surgical correction in infancy.
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disease in Americas.

Argentina · 16
Brazil · 40
Canada · 8
Chile · 4
Colombia · 25
Ecuador · 10
Mexico · 22
Nicaragua · 1
Peru · 3
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Argentina · 16 Brazil · 40 Canada · 8 Chile · 4 Colombia · 25 Costa Rica · 3 Ecuador · 10 Mexico · 22 Nicaragua · 1 Peru · 3 United States · 17
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Prices for popular procedures:
  1. Surgery for tetralogy of Fallot (TOF) in adults
    ≈ $8,970
  2. Dual chamber pacemaker insertion
    ≈ $6,785
  3. Coronary artery bypass graft (CABG)
    ≈ $12,495
  4. Off-pump coronary artery bypass surgery
    ≈ $13,230
  5. Permanent pacemaker implantation
    ≈ $7,342
  6. Radiofrequency ablation (RFA)
    ≈ $16,244
  7. Catheter cardiac ablation
    ≈ $12,243
  8. Loop recorder implantation (ILR)
    ≈ $5,337
  9. Loop recorder removal
    ≈ $1,194
photo
Barranquilla, Colombia
Specializations: Cardiac surgery, Vascular surgery, Thoracic surgery, Neurosurgery, Orthopedic surgery, Oncology
We are an institution that provides health services strategically located in the center of Barranquilla; Our clinic offers hospitalization services, intensive care unit, cardiology, general read more
Prices for popular procedures:
  1. Radical correction of tetralogy of Fallot (TOF)
    ≈ $15,047
  2. Blalock-Taussig shunt
    ≈ $9,134
  3. Surgery for tetralogy of Fallot (TOF) in adults
    ≈ $8,970
  4. Dual chamber pacemaker insertion
    ≈ $6,785
  5. Coronary artery bypass graft (CABG)
    ≈ $12,495
  6. Heart valve replacement
    ≈ $12,285
  7. Heart valve repair
    ≈ $16,595
  8. Aortic valve replacement (AVR)
    ≈ $29,252
  9. Mitral valve replacement (MVR)
    ≈ $21,006
photo
Bogota, Colombia
Specializations: Cardiac surgery, Vascular surgery, Thoracic surgery, Neurosurgery, Spine surgery, Orthopedic surgery, Oncology
The Hospital Universitario Clínica San Rafael, a university institution that provides Level IV health services, with more than 84 years of experience that support its read more
Prices for popular procedures:
  1. Surgery for tetralogy of Fallot (TOF) in adults
    ≈ $8,970
  2. Coronary artery bypass graft (CABG)
    ≈ $12,495
  3. Off-pump coronary artery bypass surgery
    ≈ $13,230
  4. Patent ductus arteriosus (PDA) open heart surgery in adults
    ≈ $3,843
  5. Septal myectomy
    ≈ $8,270
  6. Repair of the ruptured sinuses of Valsalva
    ≈ $12,318
  7. Redo heart surgery
    ≈ $17,424
  8. Atrial septal defect (ASD) repair
    ≈ $9,787
  9. Ventricular septal defect (VSD) repair
    ≈ $11,465
photo
Bogota, Colombia
Specializations: Cardiac surgery, Neurosurgery, Orthopedic surgery
Centenario is a modern hospital structure located in an area of urban growth in the center of Bogota. It has more than 9,000 m2 constructed; read more
Prices for popular procedures:
  1. Radical correction of tetralogy of Fallot (TOF)
    ≈ $15,047
  2. Blalock-Taussig shunt
    ≈ $9,134
  3. Surgery for tetralogy of Fallot (TOF) in adults
    ≈ $8,970
  4. Coronary artery bypass graft (CABG)
    ≈ $12,495
  5. Off-pump coronary artery bypass surgery
    ≈ $13,230
  6. Fontan procedure
    ≈ $15,329
  7. Radiofrequency ablation (RFA)
    ≈ $16,244
  8. Coronary catheterization
    ≈ $1,614
  9. Percutaneous coronary intervention (PCI) with stent insertion
    ≈ $8,333
photo
Puerto Colombia, Colombia
Specializations: Cardiac surgery, Vascular surgery, Thoracic surgery, Neurosurgery, Spine surgery, Orthopedic surgery, Oncology
Clínica Portoazul auna is the largest health complex in the North Region of Colombia located in the city of Barranquilla, offering comprehensive medical services to read more
Prices for popular procedures:
  1. Surgery for tetralogy of Fallot (TOF) in adults
    ≈ $8,970
  2. Coronary artery bypass graft (CABG)
    ≈ $12,495
  3. Off-pump coronary artery bypass surgery
    ≈ $13,230
  4. Coronary catheterization
    ≈ $1,614
  5. Percutaneous coronary intervention (PCI) with stent insertion
    ≈ $8,333
  6. Rotational atherectomy
    ≈ $1,659
  7. Repair of the ruptured sinuses of Valsalva
    ≈ $12,318
  8. Atrial septal defect (ASD) repair
    ≈ $9,787
  9. Ventricular septal defect (VSD) repair
    ≈ $11,465
photo
Cartagena, Colombia
Specializations: Cardiac surgery, Vascular surgery, Thoracic surgery, Neurosurgery, Spine surgery, Orthopedic surgery, Oncology
We are a private entity, dedicated to providing comprehensive health services of the highest ethical, scientific and technological quality. Operated by the Fundación Santa Fe read more
Prices for popular procedures:
  1. Surgery for tetralogy of Fallot (TOF) in adults
    ≈ $8,970
  2. Coronary artery bypass graft (CABG)
    ≈ $12,495
  3. Heart valve replacement
    ≈ $12,285
  4. Heart valve repair
    ≈ $16,595
  5. Aortic valve replacement (AVR)
    ≈ $29,252
  6. Mitral valve replacement (MVR)
    ≈ $21,006
  7. Transcatheter aortic valve replacement (TAVR)
    ≈ $33,749
  8. Off-pump coronary artery bypass surgery
    ≈ $13,230
  9. Cardiac catheterization
    ≈ $1,837
photo
Bogota, Colombia
Specializations: Cardiac surgery, Vascular surgery, Thoracic surgery, Neurosurgery, Spine surgery, Orthopedic surgery, Oncology
Clínica Universitaria Colombia, inaugurated on June 29, 2006, is a High Complexity Institution that is part of Clínica Colsanitas and that provides outpatient and hospital read more
Prices for popular procedures:
  1. Surgery for tetralogy of Fallot (TOF) in adults
    ≈ $8,970
  2. Dual chamber pacemaker insertion
    ≈ $6,785
  3. Coronary artery bypass graft (CABG)
    ≈ $12,495
  4. Heart valve replacement
    ≈ $12,285
  5. Heart valve repair
    ≈ $16,595
  6. Aortic valve replacement (AVR)
    ≈ $29,252
  7. Mitral valve replacement (MVR)
    ≈ $21,006
  8. Transcatheter aortic valve replacement (TAVR)
    ≈ $33,749
  9. Off-pump coronary artery bypass surgery
    ≈ $13,230
photo
Manizales, Colombia
Specializations: Cardiac surgery, Vascular surgery, Thoracic surgery, Neurosurgery, Orthopedic surgery, Oncology
In 2008, AVIDANTI acquired a clinic located in the Villa Pilar neighborhood of Manizales to provide highly complex services. It has a capacity over 242 read more
Prices for popular procedures:
  1. Surgery for tetralogy of Fallot (TOF) in adults
    ≈ $8,970
  2. Dual chamber pacemaker insertion
    ≈ $6,785
  3. Coronary artery bypass graft (CABG)
    ≈ $12,495
  4. Heart valve replacement
    ≈ $12,285
  5. Heart valve repair
    ≈ $16,595
  6. Aortic valve replacement (AVR)
    ≈ $29,252
  7. Mitral valve replacement (MVR)
    ≈ $21,006
  8. Transcatheter aortic valve replacement (TAVR)
    ≈ $33,749
  9. Off-pump coronary artery bypass surgery
    ≈ $13,230
photo
Santa Marta, Colombia
Specializations: Cardiac surgery, Vascular surgery, Thoracic surgery, Neurosurgery, Orthopedic surgery, Oncology
In November 2019, the Avidanti Santa Marta Clinic began operations, with the aim of supporting the needs of the Caribbean region. The facilities were modernized read more
Prices for popular procedures:
  1. Surgery for tetralogy of Fallot (TOF) in adults
    ≈ $8,970
  2. Dual chamber pacemaker insertion
    ≈ $6,785
  3. Coronary artery bypass graft (CABG)
    ≈ $12,495
  4. Heart valve replacement
    ≈ $12,285
  5. Heart valve repair
    ≈ $16,595
  6. Aortic valve replacement (AVR)
    ≈ $29,252
  7. Mitral valve replacement (MVR)
    ≈ $21,006
  8. Transcatheter aortic valve replacement (TAVR)
    ≈ $33,749
  9. Off-pump coronary artery bypass surgery
    ≈ $13,230
photo
Villavicencio, Colombia
Specializations: Cardiac surgery, Vascular surgery, Neurosurgery
The CARDIOVASCULAR CLINIC of Angiography of Colombia is the result of more than 25 years of experience in other cities of our country and 15 read more
Prices for popular procedures:
  1. Surgery for tetralogy of Fallot (TOF) in adults
    ≈ $8,970
  2. Dual chamber pacemaker insertion
    ≈ $6,785
  3. Coronary artery bypass graft (CABG)
    ≈ $12,495
  4. Heart valve replacement
    ≈ $12,285
  5. Heart valve repair
    ≈ $16,595
  6. Aortic valve replacement (AVR)
    ≈ $29,252
  7. Mitral valve replacement (MVR)
    ≈ $21,006
  8. Transcatheter aortic valve replacement (TAVR)
    ≈ $33,749
  9. Off-pump coronary artery bypass surgery
    ≈ $13,230
photo
Bogota, Colombia
Specializations: Cardiac surgery, Vascular surgery, Thoracic surgery, Neurosurgery, Spine surgery, Orthopedic surgery, Oncology
Clínica del Occidente is an accredited institution of level IV of complexity that has provided health services for 39 years. In addition, it is recognized read more
Prices for popular procedures:
  1. Surgery for tetralogy of Fallot (TOF) in adults
    ≈ $8,970
  2. Dual chamber pacemaker insertion
    ≈ $6,785
  3. Coronary artery bypass graft (CABG)
    ≈ $12,495
  4. Heart valve replacement
    ≈ $12,285
  5. Heart valve repair
    ≈ $16,595
  6. Aortic valve replacement (AVR)
    ≈ $29,252
  7. Mitral valve replacement (MVR)
    ≈ $21,006
  8. Transcatheter aortic valve replacement (TAVR)
    ≈ $33,749
  9. Off-pump coronary artery bypass surgery
    ≈ $13,230
photo
Envigado, Colombia
Specializations: Cardiac surgery, Vascular surgery, Thoracic surgery, Neurosurgery, Oncology
The ESE Hospital Manuel Uribe Ángel is an institution that provides low, medium and high complexity health services located in the municipality of Envigado, Antioquia, read more
Prices for popular procedures:
  1. Surgery for tetralogy of Fallot (TOF) in adults
    ≈ $8,970
  2. Dual chamber pacemaker insertion
    ≈ $6,785
  3. Coronary artery bypass graft (CABG)
    ≈ $12,495
  4. Off-pump coronary artery bypass surgery
    ≈ $13,230
  5. Permanent pacemaker implantation
    ≈ $7,342
  6. Radiofrequency ablation (RFA)
    ≈ $16,244
  7. Cardiac catheterization
    ≈ $1,837
  8. Percutaneous ASD closure
    ≈ $10,124
  9. Percutaneous closure of ventricular septal defect (VSD)
    ≈ $7,278
photo
Barranquilla, Colombia
Specializations: Cardiac surgery, Vascular surgery, Thoracic surgery, Neurosurgery, Orthopedic surgery, Oncology
We are an institution that provides private health services of a third level of care. We are known for providing relevant, safe, timely and warm read more
Prices for popular procedures:
  1. Radical correction of tetralogy of Fallot (TOF)
    ≈ $15,047
  2. Blalock-Taussig shunt
    ≈ $9,134
  3. Surgery for tetralogy of Fallot (TOF) in adults
    ≈ $8,970
  4. Dual chamber pacemaker insertion
    ≈ $6,785
  5. Coronary artery bypass graft (CABG)
    ≈ $12,495
  6. Heart valve replacement
    ≈ $12,285
  7. Heart valve repair
    ≈ $16,595
  8. Aortic valve replacement (AVR)
    ≈ $29,252
  9. Mitral valve replacement (MVR)
    ≈ $21,006
photo
Neiva, Colombia
Specializations: Cardiac surgery, Vascular surgery, Thoracic surgery, Neurosurgery, Spine surgery, Orthopedic surgery, Oncology
Clínica UROS SA is a private company that provides Health Services to the Surcolombian community of Medium and High complexity, at levels (3) and (4), read more
Prices for popular procedures:
  1. Radical correction of tetralogy of Fallot (TOF)
    by request
  2. Blalock-Taussig shunt
    by request
  3. Surgery for tetralogy of Fallot (TOF) in adults
    by request
  4. Pacemaker replacement
    by request
  5. Catheter cryoablation
    by request
  6. Truncus arteriosus repair
    by request
  7. Rastelli procedure
    by request
  8. Off-pump coronary artery bypass surgery
    by request
  9. Cardiac catheterization
    by request
photo
Guayaquil, Ecuador
Specializations: Cardiac surgery, Vascular surgery, Thoracic surgery, Neurosurgery, Spine surgery, Orthopedic surgery, Oncology
Languages: English
The Alcívar Hospital was founded on Thursday, November 25, 1937. It was originally called the Alcívar-Esteves Clinic, as it was directed by Dr. Eduardo Alcívar read more
Prices for popular procedures:
  1. Radical correction of tetralogy of Fallot (TOF)
    by request
  2. Blalock-Taussig shunt
    by request
  3. Surgery for tetralogy of Fallot (TOF) in adults
    by request
  4. Rectum anterior resection
    by request
  5. Surgical thrombectomy
    by request
  6. Reconstructive surgery for peripheral artery disease (PAD)
    by request
  7. Arteriovenous (AV) graft surgery
    by request
  8. Secondary Cimino arteriovenous anastomosis surgery
    by request
  9. Peripheral artery bypass
    by request
photo
Quito, Ecuador
Specializations: Cardiac surgery, Vascular surgery, Thoracic surgery, Neurosurgery, Spine surgery, Orthopedic surgery, Oncology
Languages: English
At Hospital Metropolitano we work with QUALITY, continuously improving our services. We constantly innovate processes, equipment and infrastructure to meet the needs and expectations of read more
Prices for popular procedures:
  1. Surgery for tetralogy of Fallot (TOF) in adults
    by request
  2. Endovenous laser ablation (EVLA) for varicose vein (Bilateral)
    by request
  3. Varicose vein stripping (Unilateral)
    by request
  4. Peripheral angiography
    by request
  5. Diagnostic thoracoscopy
    by request
  6. Diagnostic thoracotomy
    by request
  7. Laser interstitial thermal therapy (LITT)
    by request
  8. Removal of external fixator
    by request
  9. De Quervain's tendon release
    by request
photo
Guayaquil, Ecuador
Specializations: Cardiac surgery, Vascular surgery, Thoracic surgery, Neurosurgery, Spine surgery, Orthopedic surgery, Oncology
We are a Hospital Group that provides medical and diagnostic services, supported by state-of-the-art equipment. We offer quality care with warmth, professionalism, experience and security. read more
Prices for popular procedures:
  1. Radical correction of tetralogy of Fallot (TOF)
    by request
  2. Blalock-Taussig shunt
    by request
  3. Surgical treatment of congenital pseudarthrosis of the tibia
    by request
  4. Pediatric arthroscopy
    by request
  5. Responsive neurostimulation (RNS) insertion
    by request
  6. Multiple subpial transection (MST)
    by request
  7. Norwood procedure
    by request
  8. Fontan procedure
    by request
  9. Patent ductus arteriosus (PDA) ligation in children
    by request
photo
Guayaquil, Ecuador
Specializations: Cardiac surgery, Neurosurgery, Spine surgery, Orthopedic surgery
The Dr. Roberto Gilbert E. Children's Hospital is a non-profit hospital unit, a component of the Guayaquil Charity Board, focused on the comprehensive care of read more
Prices for popular procedures:
  1. Radical correction of tetralogy of Fallot (TOF)
    by request
  2. Blalock-Taussig shunt
    by request
  3. Surgery for tetralogy of Fallot (TOF) in adults
    by request
  4. Selective dorsal rhizotomy
    by request
  5. Intracranial hemorrhage treatment
    by request
  6. Discectomy
    by request
  7. Surgical treatment of hip dysplasia
    by request
  8. Bow legs surgery
    by request
  9. Arthroscopic biceps tenodesis
    by request
photo
Quito, Ecuador
Specializations: Cardiac surgery, Vascular surgery, Thoracic surgery, Neurosurgery, Spine surgery, Orthopedic surgery, Oncology
Languages: English
We are commited to quality and patient safety. To do this, with the leadership of Senior Management, we work towards the continuous improvement of processes, read more
Prices for popular procedures:
  1. Surgery for tetralogy of Fallot (TOF) in adults
    ≈ $8,970
  2. Dual chamber pacemaker insertion
    ≈ $6,785
  3. Coronary artery bypass graft (CABG)
    ≈ $12,495
  4. Heart valve replacement
    ≈ $12,285
  5. Heart valve repair
    ≈ $16,595
  6. Aortic valve replacement (AVR)
    ≈ $29,252
  7. Mitral valve replacement (MVR)
    ≈ $21,006
  8. Transcatheter aortic valve replacement (TAVR)
    ≈ $33,749
  9. Off-pump coronary artery bypass surgery
    ≈ $13,230
photo
Bogota, Colombia
Specializations: Cardiac surgery, Vascular surgery, Thoracic surgery, Neurosurgery, Spine surgery, Orthopedic surgery, Oncology
Méderi is a University Hospital that has an agreement with the Universidad del Rosario and other university institutions in the country, for which it bases read more
Prices for popular procedures:
  1. Radical correction of tetralogy of Fallot (TOF)
    by request
  2. Blalock-Taussig shunt
    by request
  3. Surgery for tetralogy of Fallot (TOF) in adults
    by request
  4. Dual chamber pacemaker insertion
    by request
  5. Single chamber pacemaker insertion
    by request
  6. Cardiac resynchronization therapy with pacemaker (CRT-P)
    by request
  7. Cardiac resynchronization therapy with defibrillator (CRT-D)
    by request
  8. Removal of permanent pacemaker
    by request
  9. Pacemaker replacement
    by request
photo
Quito, Ecuador
Specializations: Cardiac surgery, Vascular surgery, Thoracic surgery, Neurosurgery, Orthopedic surgery, Oncology
At the Eugenio Espejo Specialty Hospital, we work under a comprehensive humanistic philosophy, thus fulfilling the mission of providing quality and friendly health services in read more

Clinics grouping by rating

Clinic with the highest rating of 5 — New Brunswick Heart Centre in Saint John, Canada, clinic with the most reviews number of 4938 — Hospital São Camilo Pompeia in São Paulo, Brazil.

With rating 4.0 and over — 52 clinics .

Countries with the highest number of clinics treating the diseases:

Tetralogy of Fallot (TOF):

Related procedures:

Fallot's tetralogy - what is the disease?

Classification, pathophysiology of Fallot's tetralogy

Congenital heart defects are a significant medical problem. The presence of even one of them in a child can impose serious restrictions on his life, require treatment and special care; some vices are life-threatening. Tetralogy of Fallot is a combination of the four vices. This condition is quite rare, but occurs in the population, and therefore requires attention.

Anatomical disorders in tetralogy of Fallot

The defects that make up the tetralogy can also occur in isolation. However, their combination is more often detected. So, these include:

  • infundibular stenosis of the right ventricular outlet;
  • large ventricular septal defect;
  • extraposition of the aorta;
  • right ventricular hypertrophy.

Let's talk about each of these violations separately. The term "infundibular stenosis" means that there is a narrowing of the right ventricular outlet, above the valve. The valve itself is underdeveloped, its opening is narrowed. At the same time, underdevelopment and narrowing of the main trunk of the pulmonary artery, as well as branches extending from it, is possible. Sometimes they do not develop at all (more often this happens with the left branch).

The muscles of the right ventricle grow, a fibromuscular septum may appear near the valve with an opening of various diameters. All this makes it difficult for blood to exit the right ventricle. In addition, due to a ventricular septal defect, blood is ejected from the right ventricle not only into the pulmonary artery, but also into the left ventricle of the heart.

Normally, the aorta originates from the left ventricle. With Fallot's tetralogy, it is in the wrong position. The vessel is displaced to the right (dextroposition of the aorta) and lies directly above the hole in the wall of the heart. This shift closer to the right ventricle also affects hemodynamics (i.e. blood flow). Due to such an arrangement of such a large vessel, all other formations are also displaced, and as a result, the narrowing of the pulmonary artery is aggravated.

In addition to the main, always present disorders, it is possible to develop an atrial septal defect, an abnormal discharge of blood from the ventricles into the atria, and anomalies in the development of the arteries of the heart.

Causes and frequency of development of the defect

As already mentioned, Fallot's tetralogy is a congenital heart disease. It is found in 8-13% of all children with any heart defects, while it accounts for 15% of all defects requiring surgical treatment. Tetralogy of Fallot develops in 4-7% of all newborns.

The life expectancy of a child with an untreated defect depends on the degree of narrowing of the pulmonary trunk and ranges from 7 to 13 years. At the same time, in the first year of life, the mortality rate of such children is 25%, at 3 years old it is already 40%, by 10 years old - 70%, and by 40 - 95%.

Although the exact cause of Fallot's tetralogy is unknown, certain factors may increase the risk of having a child with the condition. Risk factors for tetralogy of Fallot include:

  • viral infection of the mother during pregnancy, such as rubella;
  • drinking alcohol during pregnancy;
  • poor nutrition during pregnancy;
  • mother's age over 40;
  • presence of such a defect in one of the parents;
  • presence of Down's syndrome or DiGeorge's syndrome in the fetus.

Hemodynamics

Of all four components of this disorder, the determining factor is how severe the stenosis of the outlet of the right ventricle is. Most often, only a narrowing of part of the ventricle is detected. However, sometimes it is combined with a violation of the patency of the pulmonary trunk itself and its valve. At the same time, it is assessed as a moderate patency disorder if the diameter of the vessel orifice is less than 80% of this indicator for the aortic orifice. In the event that the diameter of the pulmonary trunk is less than 50% of the aortic orifice, then the stenosis is considered severe.

If the narrowing is moderate, then the resistance to blood flow in the pulmonary artery is not so strong. Therefore, blood from the right ventricle enters only the pulmonary trunk, as it should be, without being dumped into the aorta and the left ventricle. However, even in the initial stages of the defect, blood can be discharged from left to right through an existing ventricular septal defect.

The child grows, the size of the chambers of the heart, the volume of blood and the impact force of the pulse wave increase; the degree of pulmonary stenosis also increases. All this leads to an overload of the right ventricle during systole (i.e. contraction of the muscles of the heart), because it is more and more difficult for it to push blood through a narrow vessel. Like any muscle, the myocardium of the right ventricle grows from hard work, “pumps up” - hypertrophy of the right ventricle occurs, and the pressure in it is compared with the pressure in the left. Even before the year, by 8-10 months of life, the child has a right-left shunt of blood: it occurs when straining, crying, sometimes even when sucking. Gradually, the movement of blood through the defect of the interventricular septum from right to left becomes constant, a shunt develops. Blood in the left ventricle, which is normally highly oxygenated, mixes with venous blood from the right side of the heart. As a result, all organs and tissues receive less oxygen and arterial hypoxemia develops. The size of the shunt varies depending on how much the opening to the pulmonary artery and the vessel itself are narrowed. It can range from 30 to 80% of the total blood volume per minute.

The left atrium normally receives blood from the small, pulmonary circulation (right ventricle - lungs - left atrium). However, much less blood is leaving the right ventricle than it should be. Therefore, the work of the left atrium is not enough, and it narrows, its reverse development occurs.

Among other things, as a result of displacement, the aorta receives a mixture of oxygen-rich and poor blood from the right and left ventricles.

Of course, the body is trying to adapt to changes: for example, the number of red blood cells and hemoglobin in the blood increases so that it can more efficiently saturate tissues with oxygen. An increase in the muscle mass of the ventricles is also a compensatory mechanism, because the heart eventually forces the blood to overcome the constrictions, and it somehow enters the vessels. However, the adaptive resource is running out. Organs require much more oxygen during exercise than at rest. The volume of blood flow per minute increases, the return of venous blood to the right ventricle increases. All these increases problems with hemodynamics and contributes to the discharge of more blood through the shunt between the ventricles from right to left. All this, in turn, exacerbates oxygen starvation. In addition, heart failure gradually develops.

Classification and symptoms of Fallot's tetralogy

According to the International Classification of Diseases of the 10th revision, Fallot's tetralogy belongs to category Q 21.3. The following categories are distinguished:

  • severe form;
  • classic form;
  • severe form with shortness of breath and cyanotic attacks;
  • late appearance of cyanosis;
  • pale form.

The first signs that parents pay attention to are shortness of breath, blue fingertips and lips in a child when he screams or eats. Most often, this manifests itself towards the end of the first year of life, when the level of physical activity of the child increases. Often by this time, children are lagging behind in physical development. When they begin to walk, a rather specific symptom can alert: they often squat down.

The older the child becomes, the more pronounced the symptoms: by the age of 7 years, he cannot walk even a few steps without shortness of breath.

In addition to what has been said, there are:

  • irritability;
  • prolonged crying;
  • heart murmurs;
  • faintness;
  • abnormal round shape of the nail bed on the fingers and toes (“drumsticks”).

Complications

A possible complication of tetralogy of Fallot is infection of the inner lining of the heart or heart valve caused by a bacterial infection (infective endocarditis). People with untreated tetralogy of Fallot usually develop serious complications over time - cerebrovascular accident, thrombosis, lack of oxygen, embolism. They can lead to death or disability in early adulthood.

Diagnostics

Usually, tetralogy of Fallot is diagnosed shortly after birth. In addition to outward signs, a doctor may hear an abnormal wheezing sound (heart murmur) when listening to a child's heart with a stethoscope.

Tests to diagnose tetralogy of Fallot include:

  • Measurement of oxygen level (pulse oximetry). A small sensor placed on a finger or toe measures the amount of oxygen in the blood.
  • Echocardiography, or ultrasound of the heart. Sound waves are used to create images of the heart in motion. An echocardiogram can show the structure, location, and function of the heart wall, heart chambers, valves, and aorta.
  • Electrocardiography. This method records the electrical activity of the heart with each contraction.
  • X-ray of the chest. A chest x-ray shows the structure of the heart and lungs. A common feature of Fallot's tetralogy on x-ray is a boot-shaped heart, as the right ventricle is enlarged.
  • Cardiac catheterization. Doctors can use this test to evaluate the structure of the heart and plan surgical treatment. During this procedure, the doctor inserts a thin, flexible tube (catheter) into a blood vessel, usually in the groin, and guides it toward the heart.
    The dye is passed through the catheter to make it easier to visualize the structures of the heart on x-rays. During the procedure, the doctor can measure the pressure and oxygen levels in the chambers of the heart and blood vessels.

References:

  1. CDC. Facts about Tetralogy of Fallot, 2020.
  2. Parker SE, Mai CT, Canfield MA, et al; for the National Birth Defects Prevention Network. Updated national birth prevalence estimates for selected birth defects in the United States, 2004-2006. Birth Defects Res A Clin Mol Teratol. 2010;88:1008-16.

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