Tetralogy of Fallot

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What is tetralogy of Fallot?

Tetralogy of Fallot (ToF) is a serious, congenital heart defect, affecting about two in 10,000 babies. In a normal heart, oxygen-poor (blue) blood returns to the right atrium from the body and travels to the right ventricle. Then, it is pumped through the pulmonary artery into the lungs, where it receives oxygen. Oxygen-rich (red) blood returns to the left atrium from the lungs, passes into the left ventricle and then is pumped through the aorta out to the body.

But in ToF, the abnormal features prevent enough oxygen-poor (blue) blood from flowing to the lungs as it should. As a result, a person with ToF has a lower-than-normal amount of oxygen in the blood. Surgical intervention is needed.

Tetralogy of Fallot

Children born with TOF have a combination of four cardiac anatomic characteristics:

  1. Ventricular septal defect (VSD): There is a hole between the right and left pumping chambers (ventricles) of the heart.
  2. Right ventricular outflow tract obstruction: The connection between the heart and the artery that goes to the lungs (pulmonary artery) is narrowed and blood flow to the lungs is reduced.
  3. Overriding aorta: The major blood vessel that connects the heart to the body is positioned too far to the right.
  4. Right ventricular hypertrophy: The right-sided pumping chamber (ventricle) is thicker than normal because it’s pumping blood with too much pressure

As a result of these defects, blood flow to the lungs is obstructed. The degree of obstruction generally becomes worse with time.

Care for tetralogy of Fallot

Our team in Boston Children’s Heart Center treats some of the most complex pediatric heart conditions in the world, with excellent results. Measured over the last two years, our outcomes for tetralogy of Fallot repair are greater than 92 percent survival in the first 30 days of life and greater than 99 percent survival for children beyond 30 days of age.

We are grateful to have been ranked #1 on U.S. News & World Report's list of the best children's hospitals in the nation for the third year in a row, an honor we could not have achieved without the patients and families who inspire us to do our very best for them. Thanks to you, Boston Children's is a place where we can write the greatest children's stories ever told.”
- Sandra L. Fenwick, President and CEO

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