What is Tetralogy of Fallot?
Tetralogy of Fallot is a combination of four simultaneous defects: pulmonary stenosis, ventricular septal defect, overriding aorta, and right ventricular hypertrophy. Together these four defects prevent the heart from delivering enough blood to the lungs.
Tetralogy of Fallot accounts for 7–10% of all congenital heart defects and is the most common cyanotic (blue) heart defect.
"Tetralogy of Fallot is one of the most formidable congenital heart defects. The surgery itself can be performed successfully — but caring for the patient afterwards is far from easy. Parents must learn patience and learn to trust their medical team. This is a team effort."
Symptoms
- Bluish discolouration of the skin, lips and nails (cyanosis)
- "Tet spells" — sudden severe cyanosis during crying, feeding or exertion
- Easy fatigue and reduced activity
- Squatting posture — children instinctively squat, which helps redirect blood to the lungs
- Delayed physical development
- Heart murmur
Surgery
Tetralogy of Fallot requires complete surgical repair. The operation is performed under cardiopulmonary bypass — all four defects are corrected simultaneously: the septal defect is closed, the outflow tract to the pulmonary artery is widened, and the aorta is repositioned.
Surgery is usually planned between 3 and 6 months of age. Severe tet spells may require earlier intervention.
Important for parents: After successful surgery the hardest period begins — intensive care and close monitoring. This phase can last weeks. Patience, trust in the medical team, and teamwork are the key to a good outcome.
Post-operative Period
After repair of tetralogy of Fallot the child is monitored in the intensive care unit. Heart rhythm, pulmonary pressure and oxygen levels are continuously tracked. This stage may last from several days to several weeks.
Regular cardiology follow-up is essential after discharge. Additional interventions may be needed as the child grows — this is a normal part of the process.
Long-term Outlook
Tetralogy of Fallot repaired in time means a long life. Thousands of people worldwide have grown up with this diagnosis and live fully — building families and careers. With regular cardiac follow-up, quality of life remains high.
What is a tet spell and what should I do?
During a tet spell the child suddenly turns very blue, becomes distressed and struggles to breathe. Immediately bring the child's knees to the chest (squatting position) and call emergency services. Learning to recognise this in advance is essential for parents.
How long does the operation take?
Full surgical repair usually takes 4–6 hours under cardiopulmonary bypass. Duration depends on anatomical features.
Will my child be able to live a normal life?
Yes. With timely and proper treatment children attend school, play sports, and grow up to lead fully independent lives. Regular cardiology follow-up is required, but does not significantly limit quality of life.
Will a second operation be needed?
Sometimes pulmonary valve replacement or other corrections may be needed as the child grows. These are planned procedures, not life-threatening emergencies. Each child is monitored individually.