| From your Guide Dr.MANI |  | |
Tetralogy of Fallot | ||
| From your Guide Dr.MANI | | |
Tetralogy of Fallot | ||
| |
What happens if ToF is untreated ?
A lot depends on the severity of the defect. With severe narrowing of the pulmonary valve
(pulmonary stenosis), where little or no blood flows into the lungs, the chances of survival beyond
one year of life without surgery are remote. In milder forms, children live longer. But without
treatment, the "life expectancy" is less than normal. The risk of stroke and brain abscess increase
with age. Heart failure may occur later. Constant exposure of heart muscle to blood with lesser
oxygen content makes it weak, and it "fails". This condition is called Cyanotic
Cardiomyopathy.
When should ToF be repaired ?
Many factors have to be analyzed before a decision is reached about timing and type of operation.
It might be easier if we begin by describing the operative and non-operative options available, and
how exactly they are beneficial to the child with ToF.
What are the surgical options ?
Surgery for ToF can be grouped under two major heads.
The first is called Intra Cardiac Repair (ICR) - previously called a "Total Correction". Of course,
all open heart operations are intra-cardiac repairs, but then I never said we surgeons are logical
when it comes to naming ! In this method, all the four defects of ToF are corrected in the same
operation.
The other group is called Palliative Operations. These are operations which correct the
abnormalities of ToF in a "staged" manner, by operations spread out over a few months or years.
Hold on ! Why would anyone decide to have a palliative procedure, when all the defects can be
corrected at one go with the intra-cardiac repair ?
Good question. An intra-cardiac repair is a difficult and stressful operation. Not all patients are
capable of withstanding it. Sometimes, children are too sick, or their hearts are too badly diseased,
for a single-stage operation to succeed. It is in this group that the surgeon and cardiologist will
decide to proceed carefully, in stages. When a cautious approach is followed, the ultimate outcome
is better than when a rash attempt is made at heroic one-stage repair.
So how is an Intra-Cardiac Repair operation performed ? Read on .....
 |
 |
|
Copyright 1998, All rights reserved. |
