Tetralogy of Fallot
Also known as: TOF, Fallot's Tetralogy
Tetralogy of Fallot is a congenital heart defect that consists of four structural abnormalities: a ventricular septal defect, pulmonary stenosis, right ventricular hypertrophy, and an overriding aorta. It is the most common cyanotic heart defect.
Tetralogy of Fallot is when a baby's heart has four problems that make it hard to get enough oxygen to the body, which can make the skin look blue. Doctors can fix these problems with surgery, and most children grow up to live healthy lives.
Signs & Symptoms
- Blue skin color (cyanosis)
- Shortness of breath
- Rapid breathing
- Clubbing of fingers and toes
- Poor weight gain
- Fatigue during feeding (infants)
- Squatting during exercise
- Tet spells (sudden cyanotic episodes)
- Heart murmur
Treatment Options
Complete surgical repair
CURATIVEBlalock-Taussig shunt (palliative)
MODERATELY EFFECTIVEPulmonary valve replacement
HIGHLY EFFECTIVETranscatheter pulmonary valve replacement
HIGHLY EFFECTIVE Approved 2010Prostaglandin E1 (ductal patency)
HIGHLY EFFECTIVEBeta-blockers for tet spells
MODERATELY EFFECTIVEDiagnosis
- Echocardiography
- Pulse oximetry
- Chest X-ray
- Electrocardiogram (ECG)
- Cardiac MRI
- Cardiac catheterization
- Prenatal ultrasound
History
Étienne-Louis Arthur Fallot first described this constellation of defects in 1888. Helen Taussig and Alfred Blalock pioneered the first palliative surgical treatment (Blalock-Taussig shunt) in 1944 at Johns Hopkins. Complete intracardiac repair was first performed by Walton Lillehei in 1954. Modern surgical techniques have made TOF highly treatable with excellent long-term outcomes.
Recent Breakthroughs
Advanced 3D printing for surgical planning
Patient-specific 3D printed heart models improve surgical precision and outcomes in complex TOF repairs.
Fetal intervention feasibility
Select cases of severe TOF may benefit from fetal balloon pulmonary valvuloplasty to improve postnatal outcomes.
Bioengineered pulmonary valves
Tissue-engineered valves showing growth potential may eliminate need for repeat valve replacements in children.
