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Treatments and drugs
By Mayo Clinic staff
Intracardiac repair
Tetralogy of Fallot treatment for most babies involves a type of surgery called intracardiac repair. This surgery is typically performed during the first year of life. During this procedure, the surgeon places a patch over the ventricular septal defect to close the hole between the ventricles. He or she also repairs the narrowed pulmonary valve and widens the pulmonary arteries to increase blood flow to the lungs. After intracardiac repair, the oxygen level in the blood increases and your baby's symptoms will lessen.
Occasionally babies need to undergo a temporary surgery before having intracardiac repair. If your baby was born prematurely or has pulmonary arteries that are underdeveloped (hypoplastic), doctors will create a bypass (shunt) between the aorta and pulmonary artery. This bypass increases blood flow to the lungs. When your baby is ready for a full repair, the shunt is removed.
After the surgery
While most babies do well after intracardiac repair, complications are possible. The most frequent are chronic pulmonary regurgitation, in which blood leaks through the pulmonary valve, and an irregular heartbeat (arrhythmia). Sometimes blood flow to the lungs is still restricted after intracardiac repair. Babies with these complications may require another surgery, and in some cases, their pulmonary valves may be replaced by artificial valves. In addition, there's a slight risk of infection, unexpected bleeding or blood clots. Arrhythmias are usually treated with medication.
Ongoing care
After surgery your baby will require continuing care. Your doctor will schedule routine checkups with your child to make sure that the procedure was successful and to monitor for any new problems.
Your doctor may also recommend that your child limit physical activity or take antibiotics during dental procedures to prevent infections that may cause endocarditis, an inflammation of the lining of the heart. Preventive antibiotics are recommended specifically for those who have artificial valves or who've had repair with prosthetic material.
