grouped into four types, thereby giving the name of the condition. This is supposedly a structural defect of the heart with rare detection. Usually, this condition is mired by multiple defects of the heart and its chambers, including the ventricular septal defect or VSD, pulmonary stenosis, overriding aorta and right ventricular hypertrophy.
With all these conditions present at the same time, less amount of blood reaches the lungs and consequently, less oxygenated blood passed on to the organs. Patients, especially the babies having inherent problem of Tetralogy of Fallot (TOF), usually will get cyanosis or bluish discolouration of the skin and mucous membrane. To correct the tetralogy of Fallot, open heart surgery is a requirement, but the exact timing of surgery has to be finalised after thorough assessment. Depending on the size of the pulmonary artery, surgery is usually scheduled. In India, this particular condition of the heart and its function is nowadays possible to be treated with the right surgeries and thereafter the kids can live a long life till adulthood, albeit with proper maintenance and treatment as and when required.
It is a problem of the heart, in which the developmental defects are seen and there is abnormal fusion of different points of the heart, thereby leaving out defects. But, nothing specific has been known about the performance of this particular tetralogy of defects.
Primarily, the condition of blue baby syndrome due to Tetralogy of Fallot, comprises of four different conditions of the heart, seen as a congenital heart disease. It is one of the most commonly seen congenital conditions and the most common reason for cyanotic heart disease, where the signs and symptoms cluster to form blue baby syndrome. Surgery is the mainstay of treatment in this particular case. It is about corrective surgery to be undertaken at the earliest and hence the surgery is preferably done in the first year of life. Sometimes, the corrective surgery doesn't last for a long time, creating arrhythmia, pulmonary regurgitation and re-operation. In specifically Tetralogy of Fallot, there are four important conditions, which have to be known in detail to understand about the surgical procedures to be undertaken.
In the case of right ventricular hypertrophy, there the pulmonary artery is blocked, for which the work done by the right ventricle in pushing the blood into the lungs is increased. Consequently, the ventricular musculature can increase in size.
In VSD or ventricular septal defect, which is quite common as an independent unit, there is mixing of the oxygen rich and oxygen poor blood in the two ventricles with a hole, which leads to cyanosis. Aorta, considered to be the primary artery going out from left ventricle, is placed abnormally. This placement is between the right and left ventricles.
Another part of the TOF is the pulmonary valve stenosis, as VSD is seen juxtaposed with this condition also. This condition is also responsible for cyanosis, which can be seen in case of severity of the condition.
If these abnormalities are present from the very beginning of life, then it becomes difficult to handle the situation. Not only immediate surgery is a must, but there is also the necessity to diagnose the condition rightly and take necessary palliative and life saving measures, which is done in many of the cardiology centres in india for handling Tetralogy of Fallot cases.
There have been lots of theories about the causation of the condition of Tetralogy of Fallot, but this being a congenital heart disease, will be difficult to be predicted. When Tetralogy of Fallot is seen in an individual, it helps if there is surgery done at the earliest. But, before doing so, proper assessment about the exact condition is to be judged by taking into account the symptoms. Cyanosis is one of the major symptoms found with TOF. There is also associated difficulty in breathing, tiredness, sleepiness, fussy and patients may pass out repeatedly. Heart murmur is very much clearly heard, in this condition. There is absence of weight gain because of the lack of eating in children. All these symptoms gradually increase in intensity, if the condition is seen to be prolonged. While surgery is usually advised, there can be other palliative measures, until the child is fit enough for surgery.
When the surgery is done for Tetralogy of Fallot, people are usually not aware of the benefits, which is therefore explained by the operating doctor or advised in detail. Medical treatment may help the child to be fit for some days, which is helpful in increasing the flow to the pulmonary artery and to the lungs.
The operation through open heart surgery requires presence of competent people, including paediatric surgeon, cardiac surgeons and expert team of nurses and assistants. There is obvious increase in blood flow to the lungs. But then, there are so many ways to repair the TOF and add to the blood supply reaching into the systemic circulation. There is usually a shunting procedure, where the blood flow to the pulmonary artery is carried out from the vena cava. In another process, the ventricular septal defect is to be closed, which can be easily done through same operative process by open heart surgery. Sometimes, temporary and palliative surgery is possible.
Indian hospitals doing the open heart surgery also include patients with tetralogy of Fallot. Since there are four different defects to be fulfilled, the Indian cardiologists usually take about 4 hours to complete the operative steps. In some cases, especially the children, the Tetralogy of Fallot has become difficult to be operated for which the staff of the hospital is well trained. They have plenty of resources to make sure that the little plan is successful and Indian patients as well as from those outside, get to have their TOF corrected with advanced diagnostic machines and well skilled doctors in India.