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TETRALOGY OF FALLOT

INTRODUCTION
Tetralogy of Fallot, which is one of the most
common congenital heart disorders,
comprises right ventricular (RV) outflow tract
obstruction (RVOTO) (infundibular stenosis),
ventricular septal defect (VSD), aorta
dextroposition, and RV hypertrophy.
DEFINITION
A heart defect that features four problems.

They are:
A hole between the lower chambers of the heart
An obstruction from the heart to the lungs
The aorta (blood vessel) lies over the hole in the lower chambers
The muscle surrounding the lower right chamber becomes overly
thickened
Sign and symptom
Investigation
FBC :
Hemoglobin and hematocrit values are usually elevated in
proportion to the degree of cyanosis. Patients with significant
cyanosis have the following, in association with a tendency to
bleed:
Low platelet count due to decreased clotting factors

PT/APTT/INR :
Diminished coagulation factors
Diminished total fibrinogen
Prolonged prothrombin and coagulation times
ABG :
Oxygen saturation varies
pH and pCO2 are normal unless the patient is in
extremis
Imaging studies include :

Echocardiography
Chest radiographs
Magnetic resonance imaging (MRI
Echocardiography has the following attributes:
Color-flow Doppler echocardiography accurately diagnoses
ductus arteriosus, muscular VSD, or atrial septal defect
Valvar alterations can be detected with ease
Echocardiography is the only diagnostic study used before
surgery
Chest radiographs attributes:
Often normal initially
Diminished vascularity in the lungs and diminished
prominence of the pulmonary arteries gradually become
apparent
The classic boot-shaped heart is the hallmark of the disorder
Cardiac catheterization findings :
Assessment of the pulmonary annulus size
and pulmonary arteries
Assessment of the severity of Right Ventricular
Outflow Track Obstruction ( RVOTO )
Location of the position and size of the VSD
Ruling out possible coronary artery anomalies
Cardiac Catheterization
TYPE OF OPERATION :
Complete Intracardiac Repair
Widen the narrowed pulmonary blood vessels. The
pulmonary valve is widened or replaced. Also, the passage
from the right ventricle to the pulmonary artery is
enlarged. These procedures improve blood flow to the
lungs. This allows the blood to get enough oxygen to meet
the body's needs.
Repair the ventricular septum defect (VSD). A patch is used
to cover the hole in the septum. This patch stops oxygen-
rich and oxygen-poor blood from mixing between the
ventricles.
Temporary or Palliative Surgery
The surgeon places a tube between a large
artery branching off the aorta and the
pulmonary artery. The tube is called a shunt.
One end of the shunt is sewn to the artery
branching off the aorta. The other end is sewn
to the pulmonary artery.
The surgeon removes the shunt when the
baby's heart defects are fixed during the full
repair.
MANAGEMENT

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