The heart is the most important organ for the survival of any living being as it has the most important of jobs of all the organs as it pumps blood throughout the body for all the organs to work with efficiency. As important as the heart may be, it still is considered one of the more delicate and vulnerable of the organs in the body. The heart should be maintained like a well-oiled machine for the rest of the human body to function with efficacy. If the heart is stressed even a little more than it should be, then the whole body might have to suffer the consequences in the long run.
What exactly is Tetralogy of Fallot?
Tetralogy of Fallot is a form of heart disorder that is present at birth (congenital). It is defined as the combination of four heart defects. These disorders affect the structure of the heart causing oxygen-poor blood to flow from the heart to the rest of the body. Those defects being – ventricular septal defect (VSD), pulmonary stenosis, right ventricular hypertrophy and overriding aorta.
What defects make up to form Tetralogy of Fallot?
There is a decrease in the normal flow of blood because of a muscular obstruction just below the pulmonary valve in the right ventricle. There may also be a decrease noticed in the size of the pulmonary valve.
Right Ventricular Hypertrophy
This defect occurs when the blood pumping action of the heart requires more work than necessary to pump the blood throughout the body forcing the walls of the heart to thicken or swell, which in turn make the heart more stiff and weak leading to the eventual failure of the heart.
Ventricular Septal Defect (VSD)
In this disorder, there is a hole in the wall between the two ventricles (lower heart chambers). This hole allows the de-oxygenated blood from the right ventricle (after circulating through the body) to flow into the freshly oxygenated blood in the left ventricle (to be sent to all the organs).
In normal cases, the aorta which is the main artery that leads out to the rest of the body subdivides the left ventricle. But in the case of tetralogy of fallot (TOF), the position of the aorta is shifted slightly to the right positioning it right above the ventricular septal defect. Due to this, the aorta receives blood from both the ventricles mixing the de-oxygenated blood from the right ventricle with the fresh-oxygenated blood from the left ventricle.
Some adults or children who suffer with TOF may also be experiencing some other form of heart defect as well, such as the atrial septal defect (a hole between the upper heart chambers), abnormalities of the coronary arteries or a right aortic arch.
Preliminary diagnosis for Tetralogy of Fallot (TOF)
As soon as the diagnosis proves the existence of TOF in the newborn, the immediate focus of the medical experts will be to check for the oxygen levels of the child and determine whether the child is in the safe zone yet. Soon after the birth, if the child is found out to have lower oxygen levels than required, then an infusion of prostaglandin is normally initiated to keep the ductus arteriosus open which provides additional blood flow and increases the oxygen level in the child. After this, the child will generally require to undergo surgery in the neonatal period. In the case of infants with mild cyanosis (discolouration due to low oxygen level) or normal oxygen levels, the discharge usually takes place in the first or the second week.
How to know the eligibility for the treatment of TOF?
The medical experts will determine a specified treatment for the infant on the basis several conditions. These conditions include – health of the child, age and medical history, severity of the disorder & allergy or compatibility with specific medications or procedures. Depending of these factors, the determination and application of a procedure will be carried out for the betterment of the child.
Diagnosis and Treatment for Tetralogy of Fallot
The child with TOF will experience TET spells, in which the child will suddenly develop blue lips nails and skin because of agitation or crying or even feeding. These spells are caused by a sudden fall in the level of oxygen in the blood. Mild TET spells can be dealt with by using beta-blockers such as propranolol but severe and acute episodes will have to be tackled with a swift intervention with intranasal fentanyl or morphine.
Total Surgical Repair
This procedure is considered a curative method for TOF. This method has two main steps – widening of the narrowed pulmonary vessels and closing of the ventricular septal defect. Careful resection of the heart muscle is done to relieve the stenosis of the right ventricular outflow tract which is enlarged using a patch hence repairing the VSD. Depending on the cardiac anatomy, the patient may require additional reconstructive or reparative surgery.
This surgery is performed as a temporary alternative for Total Surgical Repair as in some infants it is impossible to carry out this procedure. In this surgery, a shunt (tube) is placed between the artery that divides the aorta and the pulmonary artery. One end of the shunt is sewn to the pulmonary artery and the other to the aorta. This improves the travel of blood to the lungs. This shunt is removed during the procedure for total surgical repair.
Why choose India for your Tetralogy of Fallot treatment?
India is gaining fame in the medical world for being the best destination to receive any kind of procedure. The technological advancements that India has gone through are huge and the medical facilities & advanced equipment available in India are on par with that of the most developed of the nations. The surgeons in India are also famed for being one of the most, if not the most, experienced personnel having performed various complex surgeries in countries like, Netherlands, Germany, Switzerland, France, UK, USA, Canada and many more. While the medical technology and the related experts in India are of the highest quality, the expense associated with them is very less. The cost of medical procedures in India is very less, in fact so less that sometimes it dips to the range of 40-60% of the actual price in the western countries.
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