The Heart Center at Nationwide
Children's is dedicated to the unique needs of its patients.
One of the conditions the center supports is tetralogy of fallot. Tetralogy
of fallot is a heart defect made up of four heart problems. It results in
cyanotic or blue babies. The four heart problems are ventricular septal defect,
overriding aorta, pulmonary stenosis and right ventricular hypertrophy. A
ventricular septal defect is a hole in the wall between the two lower chambers
of the heart called the ventricles. The hole allows oxygen-rich blood to mix
with oxygen-poor blood. Normally the aorta attaches to the left ventricle
which pumps oxygen-rich blood through it. In an overriding aorta, the aorta has
moved forward directly over the hole between the ventricles. This allows
oxygen poor blood from the right ventricle to flow into the aorta.
Pulmonary stenosis means that the blood vessel going to the lungs called the
pulmonary artery is narrowed and the pulmonary valve doesn't open all the way.
As a result less blood reaches the lungs. These heart problems cause the baby to
be blue because the heart pumps less oxygen-rich blood to the body. Right
ventricular hypertrophy means the wall of the right ventricle is thicker than
normal. This happens because the right ventricle
has to work harder to pump blood through the narrowed pulmonary valve. Treatment
for tetralogy of fallot may include temporary and complete surgical repair
procedures. Sometimes a child is not ready for a complete repair right away.
In this case a temporary repair called a shunt can be placed until a complete
repair can be done. The shunt improves oxygen levels in the blood. During this
procedure the surgeon will place a tube called a shunt between a branch of the
aorta and the right pulmonary artery. The shunt will provide another path for
blood to get to the lungs to pick up oxygen. Instead of a shunt another
temporary procedure can be done. In this procedure a device called a stent is
placed in the narrow area to allow more blood to flow to the lungs. Most patients
have a complete repair at four to six months of age. If the main pulmonary
artery is too small it will be widened with a patch. If the pulmonary valve is
too small it may be widened with a patch called a transannular patch. If the
narrowing is below the pulmonary valve the surgeon will remove some of the
heart muscle in this area. This improves the flow of oxygen poor blood from the
right ventricle to the lungs. To fix the ventricular septal defect
the surgeon will cover the hole with a patch. The patch prevents the mixing of
oxygen poor blood with oxygen-rich blood. As a result only oxygen-rich blood flows
out of the aorta to the body from the left ventricle. The Heart Center team at
Nationwide Children's is dedicated to supporting your child. We are available
to answer all of your questions at any time at 614-722-2530 and at Nationwidechildrens.org/Heart.