Tetralogy of Fallot Disease is one of the common congenital heart diseases in newborns. When the baby cries due to the serious condition, the skin, lips or limbs will turn blue-purple due to lack of oxygen, making many new parents nervous for a while. .

What exactly are the four severe diseases of Fallot? What are the symptoms and characteristics? Can it be cured?

What are the Tetralogy of Fallot Disease?

Fallot’s Tetralogy is one of the congenital heart diseases discovered by French physician Étienne-Louis Arthur Fallot in 1888. The hearts of patients with severe cases of Fallot’s disease have the following four characteristics:

1. Right ventricular outlet stenosis:
   The most important characteristic of Fallot’s four severe cases. Due to the narrowing of the right ventricular outlet, relatively little blood is sent to the lungs for gas exchange, resulting in symptoms of hypoxia and cyanosis in children after birth.
   
2. Midventricular septum defect:
   The midventricular septum is the diaphragm that separates the left and right ventricles. Patients with severe Fallot syndrome will suffer from midventricular septum defect. When pulmonary artery stenosis increases the pressure in the right ventricle, some blood will pass through the defect. It flows into the left ventricle, causing a mixture of hypoxic blood and oxygenated blood to be transported throughout the body, resulting in a decrease in the amount of oxygen carried by organs throughout the body, which can easily cause cyanosis in babies.
   
3. Straddle of the aorta:
   Due to the defect of the diaphragm in the ventricle, blood from the left and right ventricles of the patient can be sent to the whole body through the aorta. This is called straddle of the aorta, and because the blood in the right ventricle is hypoxic blood that has not yet passed through the pulmonary circulation, , patients are prone to cyanosis due to lack of adequate oxygen supply.
   
4. Right ventricular hypertrophy:
   Based on the above, less blood enters the pulmonary artery in patients with severe symptoms of Fallot’s disease. In order to make up for the amount of blood, the right ventricle has to beat harder, which ultimately leads to compensatory damage to the right ventricular myocardium. Thickening and hypertrophy.

Three major symptoms of Tetralogy of Fallot disease: cyanosis, hypoxia, and clubbing

Affected by the above-mentioned cardiac structural abnormalities, the oxygen content of systemic organs in children with severe Fallot syndrome will decrease, which will lead to the following symptoms:

1. Cyanosis:
   Due to the decrease in oxygen-carrying blood throughout the body, the sick child’s skin, lips, and nails turn blue-purple, so he is also called a Blue Baby.
   
2. Hypoxia:
   Symptoms such as paleness, confusion, agitation, and shortness of breath occur when sick children cry.
   
3. Clubbing of fingers:
   The ends of the fingers and toes are ball-shaped, and the swelling is thicker than the joints. They feel soft to the touch when pressed, and there is a feeling of edema.

Treatment of Tetralogy of Fallot disease: The success rate of surgery is over 90%

If Tetralogy of Fallot disease are not properly treated, nearly 35% of children with the disease will not live longer than 1 year old, and only 50% of them will survive beyond 3 years old. However, only 5% will eventually grow up.

The main treatment method for Tetralogy of Fallot disease is “total corrective surgery”; the defect of the ventricular septum and the stenosis of the right ventricular outlet are repaired through surgery. After total corrective surgery, the child’s heart structure tends to be normal, and there will be a certain degree of pulmonary artery reflux and stenosis. However, generally full corrective surgery can only be performed after the baby is 3 months old, and the success rate of the surgery is high.

Does it take three months to be “fully corrected”? So what should I do if my skin becomes very dark after birth?

Since full corrective surgery cannot be performed until the child is 3 months old, some children are severely cyanotic after birth and need to rely on a respirator or even be intubated, let alone being discharged from the hospital! What to do at this time?

At this time, “staged surgery” will be used to temporarily solve the child’s cyanosis problem, so that the baby can be weaned from the respirator, grow up slowly, and even be discharged from the hospital. Wait until the child is old enough and heavy enough to undergo full corrective surgery.

The first stage of surgery currently involves the following procedures:

1. Artificial vascular shunt:
   The doctor will use surgery to drain the innominate artery and the right pulmonary artery with an artificial blood vessel to increase blood flow to the lungs. In this way, the symptoms of hypoxia and cyanosis can be improved. The surgery will be performed after the baby has grown up.
   
2. Cardiac catheterization surgery:
   Doctors will use a cardiac catheter to place a metal stent in the open arterial duct or right ventricular outlet to increase blood flow to the lungs and improve blood oxygen levels. Wait until the patient is 3 to 6 months old and the pulmonary blood vessels are fully developed, and then the above-mentioned surgery can be used to correct it.

“Individual differences in Tetralogy of Fallot disease are very large, and every child’s condition is different. Therefore, some children are suitable for surgery, and some are suitable for cardiac catheterization. All these must be evaluated by a cardiologist so that the child can receive the best treatment. Treatment!”
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Regular follow-up is required after surgery, and returning to normal life is not a dream!

​After surgery, most of the sick children live to adulthood and can engage in various sports and jobs. However, some patients who have undergone surgery may develop the following symptoms decades later

1. Right ventricular outlet pulmonary atresia
   
2. Myocardial fibrosis
   
3. Right ventricular failure
   
4. Arrhythmia

In view of this, it is recommended that patients with Tetralogy of Fallot Disease still need to undergo long-term follow-up to evaluate the function of the heart. If arrhythmias occur, implantation of a rhythm regulator can be considered to avoid danger.